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What is Melasma: Causes, Symptoms, Treatment

What is Melasma?

Melasma is quite a common dermatological condition that affects the pigmentation of the skin. It is characterized by the presence of brown or gray colored patches on the skin surface. The most common area where these patches can be seen is the face and can be unsightly. The areas in the face where Melasma develops include bridge of the nose, temples, cheeks, and lips.[1,2,3]

Sometimes, Melasma can also appear on other areas of the body, especially those that are exposed to direct sunlight for long periods of time like hands, forearms, and neck. Melasma tends to have a female gender bias as various studies suggest that only 10% males get this condition. Melasma is seen more in pregnant females and females who are dark in complexion.[1,2,3]

What is Melasma?

What Causes Melasma?

The root cause of Melasma is not completely understood by researchers. The most common theory that has been suggested is abnormal functioning of the melanocytes as a possible cause for this condition when they start producing excessive color. This is the reason why people with dark skin get this condition more than fair complexion people as their melanocyte count is much more.[3]

There are also some triggers which may result in the development of Melasma. These triggers include hormonal changes. This is generally seen in pregnant females.

Hormonal changes may also occur if a female is on hormone therapy or is taking birth control pills.[3]

As stated, excessive exposure to direct sunlight can also trigger Melasma. There are plenty of skin care products available in the market. However some of these products contain chemicals that may irritate the skin resulting in Melasma. Some experts suggest a genetic link to the development of Melasma as it has been observed that Melasma tends to run in families.[3]

What Causes Melasma?

What are the Symptoms of Melasma?

The primary presenting feature of Melasma is the development of gray and brown colored patches on the skin surface generally on the areas of the face like the forehead, cheeks, and bridge of the nose. These patches tend to look unsightly even though it does not cause any other symptoms. It is just the appearance of these patches that bothers people than anything else. Sometimes, these patches may also be found in the neck and forearms as these areas are also frequently exposed to direct sunlight for long periods of time.[3]

How is Melasma Treated?

As Melasma does not cause any discomforting symptoms, treatment often is not required. For cases where hormonal changes or pregnancy are believed to be the cause then these patches fade away after delivery of the child or once the person stops taking pills that bring about a change in the hormone levels. In other cases, Melasma can last for years. However, if a person finds that Melasma is hurting them cosmetically then they have the choice to get them removed.[3]

It should be noted that the success rate of such treatments is questionable and may not work for everyone. The treatment options for Melasma include[3]

Medications: The most common medication used for Melasma is called hydroquinone. It comes in the form of a lotion and can be applied directly to the affected area to lighten up the patches. This medication is often the first line of treatment for people with Melasma. It also comes in the form of a gel or cream. Hydroquinone can be bought over the counter but if a stronger cream is required then a prescription will be needed.[3]

If hydroquinone is not found to be effective then the person may be given corticosteroid and tretinoin creams. Both these creams help lighten up the skin and get rid of the abnormal patches. In some cases, a physician may prescribe a combination of corticosteroids, tretinoin, and hydroquinone creams all mixed into one for better efficacy. Additionally, use of azelaic and kojic acid are also found to be effective in getting rid of Melasma patches.[3]

Medical Procedures: If all the above mentioned conservative procedures are not found to be effective in treating Melasma then the person can opt for certain dermatological procedures to lighten up the affected skin and get rid of the patches. These procedures include microdermabrasion, chemical peeling, and laser treatment. All these treatments can be done at a local skin care clinic.[3]

The individual should thoroughly research about the clinic before going for these procedures as it requires skilled and experienced professionals to perform these procedures for better effectiveness. Some of the treatment options mentioned above have certain side effects and may cause other skin problems and thus it is better to consult with a physician before starting any medication to treat Melasma.[3]

After treatment, it is always better to avoid triggers to prevent recurrence of Melasma to include avoid prolonged sun exposure and using sunscreens over the exposed area of the body especially in the summer months.[3]

In conclusion, Melasma is quite a common dermatological condition that causes dark patches of skin generally on the face and other areas of the body that are exposed to direct sunlight like the neck and the hands. These patches are completely harmless and do not pose any health threat. However, people tend to find these patches unsightly and prefer to get these removed. Melasma is commonly seen in females than males.[1,2,3]

The root cause of Melasma is not known but it is believed that hormonal changes and pregnancy may trigger it. There are a variety of treatment options available for Melasma in the form of creams, lotions, gels, and even surgical procedures. Melasma in cases of pregnancy and hormonal changes fades away on its own. However, some of the treatment options have side effects and thus it is recommended to consult with a dermatologist before starting any treatment for Melasma.[1,2,3]


Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 11, 2022

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