Melasma

What is melasma?

People with melasma get dark patches on the parts of their skin exposed to the sun. After the patches appear, they do not go away. They can get darker and larger.

The cause is not fully known. Causes can be genetics, hormones, and sunlight. It is most common in premenopausal Latino, African American, Asian, and Native American women. Many people have a family history.

How do I know if I have melasma?

You will have:

  • Tan to brown patches, darker than your normal skin color in different patterns on your face. The shade of brown depends on the depth of pigment in the skin.
  • Patches may be on your forehead, cheeks, upper lip, nose, and near the jawline.

How do you treat melasma?

  • There is no cure.
  • It cannot hurt you and does not have to be treated.
  • It is hard to treat for many reasons:
    • The color of the patches can get darker in the sun.
    • Topical medicines do not work well if the pigment is deep in the skin.
  • Some people want the patches faded for cosmetic reasons. This can be done by using:
    • Topical creams
    • Laser treatment
    • Chemical peels
  • Topical creams like hydroquinone are the first treatment to try.
  • Use sunscreen daily, with at least:
    • SPF 30
    • Broad-spectrum coverage
    • Physical blockers, such as titanium dioxide and zinc oxide

Even small doses of sunlight can make patches worse. Read about sunscreen for more facts.

Last reviewed: 
July 2017

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