Melasma: Overview

Melasma is most common in women

Many women first see these blotchy patches and freckle-like spots on their face during pregnancy or when they start taking birth control pills. Melasma is so common during pregnancy that it’s sometimes called the “mask of pregnancy.”

For some women, the melasma goes away after their baby is born or they stop taking birth control pills.

Melasma often begins during pregnancy

The blotchy brownish areas and freckle-like spots on this woman’s face are melasma, which first appeared while she was pregnant.

Women who have medium to dark skin tones are most likely to develop melasma. When melasma appears, it can cause tan, brown, grayish brown, or bluish gray patches and freckle-like spots. These usually appear on certain areas of face like the cheeks, forehead, chin, and even above the upper lip. While less common, melasma can develop on the arms, neck, or elsewhere.

What can get rid of melasma?

While melasma may go away on its own, this skin condition can also last for years.

If you dislike the discoloration on your skin caused by melasma certain treatments can sometimes help. Dermatologists recommend treating melasma sooner rather than later. It can be difficult to get noticeable results from treatment if you’ve had melasma for many years.

However, if you are pregnant, wait until you have your baby to treat melasma. If you use a melasma treatment that you can buy without a prescription, it can be difficult to know whether it’s safe to use during pregnancy. Also, melasma may improve and sometimes even go away after you give birth.

Is there a cure for melasma?

Treatments such as creams can help fade the discoloration, but treatments cannot make melasma go away forever. This skin condition can come back. It's common for melasma to return when you spend time outdoors without protecting your skin from the sun.

In fact, many people who have melasma say the dark spots and patches become more noticeable during the summer and fade in winter. For this reason, it is important to use sunscreen every day and wear a wide-brimmed hat to keep the spots from getting darker or returning.

Is melasma a type of cancer?

No, melasma is not a type of cancer. It’s also not a sign of skin cancer. Melasma differs from skin cancer in that it typically feels flat and appears on both sides of your face.

How can a board-certified dermatologist help with melasma?

If you have discolored patches or freckle-like spots on your skin, seeing a dermatologist can help ease your mind. A board-certified dermatologist can tell you whether melasma or another condition is causing the skin discoloration.

If you have melasma, a dermatologist can create an individualized treatment plan for you. Treatment usually begins with sun protection and creams that you apply to the melasma.

Many people who have a darker skin tone see a dermatologist for melasma treatment. In fact, treatment for melasma is one of the most common reasons that people who have a darker skin tone see a dermatologist.

Dermatologists understand that treating melasma in darker skin tones requires a different approach from treating melasma in lighter skin tones. For example, some melasma treatments can irritate darker skin, which can worsen melasma and make it darker.

Dermatologists know which precautions to take to prevent treatments from worsening melasma in darker skin tones. They also understand that it usually takes longer to see results from treatment if you have a dark skin tone.

It’s important to know that no matter your skin tone, melasma can be stubborn. Some people need a prescription strength-cream, procedure, or both.

If you use a non-prescription melasma treatment, dermatologists recommend using it for no longer than three to six months

If you don’t get the results you want by then, see a dermatologist for treatment.

A dermatologist can also help you with sun protection. To get results from treatment, you need to protect your skin from the sun every day.

Still wondering if you may have melasma? You’ll find more pictures of melasma that show you what this skin disorder can look like at: Melasma: Signs and symptoms.

Images
Image 1: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2: Getty Images

References
Chaowattanapanit S, Silpa-Archa N, et al. “Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention.” J Am Acad Dermatol. 2017 Oct;77:607-21.

Ogbechie-Godec OA, Elbuluk N. “Melasma: An up-to-date comprehensive review.” Dermatol Ther (Heidelb). 2017;7(3):305-18.

Pandya AG, Rivas S, “Melasma.” In: Taylor and Kelly’s Dermatology for Skin of Color. (second edition). McGraw Hill, USA, 2016:356-9.

Sheth VM, Pandya AG. “Melasma: A comprehensive update. Part 1” J Am Acad Dermatol. 2011;65:689-97.

Written by:
Paula Ludmann, MS

Reviewed by:
Arturo Dominquez, MD, FAAD
Ivy Lee, MD, FAAD

Last updated: 2/15/22