What Is It?
Melasma is a condition in which areas of the skin become darker than the surrounding skin. Doctors call this hyperpigmentation. It typically occurs on the face, particularly the forehead, cheeks and above the upper lip. The dark patches often appear on both sides of the face in a nearly identical pattern. The darker-colored patches of skin can be any shade, from tan to deep brown. Rarely, these dark patches may appear on other sun-exposed areas of the body.
Melasma occurs much more often in women than in men, and usually is associated with hormonal changes. That is why the dark patches develop often during pregnancy, or if a woman is taking hormone replacement therapy (HRT) or oral contraceptives. Melasma during pregnancy is relatively common. Sometimes it is called the "mask of pregnancy" or "chloasma." The dark patches typically last until the pregnancy ends.
The most important factor in the development of melasma is exposure to sunlight. Using medications that make you sensitive to the sun (photosensitizing) can increase your risk of developing melasma. These can include some cosmetics and medicines used to treat ovarian or thyroid problems. Protection from the sun is a necessary part of treatment of melasma. For example, women who are pregnant or who take a hormone medication and avoid the sun are less likely to develop melasma than are those who spend a lot of time in the sun.
Darker patches of skin appear on the forehead, temples, cheeks or above the upper lip. The symptoms are strictly cosmetic -- you won't feel ill, and the darker skin won't be sore.
A doctor will diagnose melasma simply by looking at your skin. Your medical history will help to determine any factors that may have caused the disorder.
Your doctor may use a special lamp that gives off ultraviolet light. This allows the doctor to see patterns and depth of skin discoloration more clearly.
The dark patches typically last until the pregnancy ends or you stop taking the hormonal medications and protect from the sun. The patches gradually fade over many months. In some people, the discoloration never entirely disappears.
The best way to prevent melasma is to limit skin exposure to the sun. If you go out in the sun, take these preventive measures:
As hormones stabilize, the dark patches of melasma usually fade. Women who develop melasma as a result of pregnancy often see the patches fade months after the baby is born. Women who take oral contraceptives or hormone replacement therapy often see the patches fade once they stop taking the medications.
A few options may help fade or treat dark patches:
When to Call a Professional
See your doctor if you develop any unexplained discoloration of the skin. Although melasma does not require treatment, a doctor can distinguish melasma from other skin disorders that may need to be treated.
Much of the discoloration will fade or disappear once hormones stabilize and you stay out of the sun. For people who find the discolorations unsightly, treatment may help to fade stubborn patches. You also can use cosmetics to even out the skin color.
American Academy of Dermatology
P.O. Box 4014
Schaumburg, IL 60168-4014
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675