• Melasma



    Melasma is a skin condition where brown patches appear on the skin. These patches usually appear on the cheeks, nose, forehead, chin, and upper lip. Patches can also appear on the neck and forearms.
    Because it is common in pregnant women, melasma may be referred to as the mask of pregnancy.
    Common Sites on the Face for Melasma
    AM00013 face
    Copyright © Nucleus Medical Media, Inc.


    The brown patches are due to an increased amount of melanin in the skin. The exact cause of increase in melanin is unknown. It is thought to be associated with hormones such as estrogen and progesterone. Sun exposure also plays a major role.

    Risk Factors

    Melasma is more common in women during their reproductive years, but it can occur in men. Other factors that increase may your chance of melasma include:
    • Family history of melasma
    • Having a darker skin tone
    • Pregnancy
    • Getting too much sun exposure
    • Taking birth control pills
    • Using products that irritate the skin, such as cosmetics
    • Certain medications, such as antiseizure drugs or hormone therapy


    The only sign of melasma is dark patches of skin. It is not painful or itchy.
    Not all brown patches on your skin are melasma. Talk to your doctor about changes in your skin.


    You will be asked about your symptoms and medical history. Your skin will be examined. A lamp, called a Wood’s lamp, may be used to look at your skin. A small sample of skin may be taken for a biopsy. The sample will be sent to a lab to confirm the diagnosis.


    Melasma may go away on its own. If it does not go away, it may need to be treated. In general, treating melasma can be difficult. Talk with your doctor about the best treatment plan for you.

    Removing Cause

    Factors that are causing the melasma may be removed. For example:
    • Melasma associated with pregnancy may slowly fade after giving birth.
    • Melasma associated with birth control pills or hormone replacement therapy may fade after the medication is stopped.
    Melasma can reappear and become darker if you become pregnant again or resume taking medication.
    Avoid using products that can irritate your skin. These include make-up, creams, and cleansers.

    Ultraviolet Light Protection

    Protecting your skin from UV light is important in helping to fade melasma. This means avoiding sun and tanning bed exposure. Your doctor may advise wearing sunscreen, clothing, and hats when outdoors.

    Depigmenting Medications

    Certain medications, like bleaching creams, are used to lighten skin color. A common bleaching cream used to treat melasma is hydroquinone. This may also be used with other creams or combination of creams such as tretinoin, corticosteroids, azelaic acid, or glycolic acid. These creams enhance the skin-lightening effect.
    Your skin may be sensitive to these medications. Use care and start slowly when first using them. It may take several months before you see an improvement.

    Other Treatments

    Other treatments remove outer layers of the skin. These include:
    • Chemical peel
    • Microdermabrasion—removing top layer of skin
    • Laser therapy


    To help reduce your chance of getting melasma:
    • Limit the amount of time you spend in the sun. Avoid using tanning booths.
    • Use sunscreen daily. Wear sunscreen that protects against both UVA and UVB rays and has an SPF of 30 or more.


    American Academy of Dermatology http://www.aad.org

    Family Doctor—American Academy of Family Physicians http://familydoctor.org


    Canadian Dermatology Association http://www.dermatology.ca

    Public Health Agency of Canada http://www.phac-aspc.gc.ca


    Gupta AK, Gover MD, Nouri K, Taylor S. The treatment of melasma: a review of clinical trials. J Am Acad Dermatol. 2006;55(6):1048-1065.

    Melasma. American Academy of Dermatology website. Available at: http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/m---p/melasma. Accessed June 4, 2015.

    Melasma. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=Melasma. Accessed June 4, 2015.

    Melasma. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/melasma.html. Updated April 2014. Accessed June 4, 2015.

    Prignano F, Ortonne JP, Buggiani G, Lotti T. Therapeutical approaches in melasma. Dermatol Clin. 2007;25(3):337-342.

    Tierney EP, Hanke CW. Review of the literature: Treatment of dyspigmentation with fractionated resurfacing. Dermatol Surg. 2010 Oct;36(10):1499-508.

    Treatments of common complaints in pregnant women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 11, 2014. Accessed June 4, 2015.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.