Melasma

3 min read·Last updated: 2026-02-07·Reviewed by Dr. Julia Tzu, MD, FAAD, FACMS

At a Glance

Melasma is a common skin condition that causes brown or gray-brown patches, typically on the face. The name comes from the Greek word for “black spot.” Often called the “mask of pregnancy” because it frequently affects pregnant women, melasma occurs when melanocytes (pigment-producing cells) produce excess melanin. The patches typically appear on the cheeks, forehead, bridge of nose, chin, and upper lip. Between 33% and 50% of people with melasma have a family history of the condition, suggesting a genetic component. While harmless, melasma can be cosmetically distressing and may require ongoing management.

Between 33% and 50% of people with melasma report having a family member with the condition[1]
Sun exposure triggers melanin production and is a primary cause of melasma development and recurrence[3]
Melasma from pregnancy often fades after delivery, though it may persist in some cases[2]
Treatments can fade discoloration but cannot make melasma go away permanently[2]

Symptoms

Brown or gray-brown patches on the face
Symmetric pattern on both sides of the face
Patches with well-defined or blurry borders
Darker patches on cheeks, forehead, nose bridge, chin, and upper lip
Patches that darken with sun exposure
Discoloration on forearms or neck (less common)

When to Seek Professional Care

Facial discoloration that bothers you cosmetically
Dark patches appearing during pregnancy or with hormone use
Desire for treatment to reduce pigmentation
Concern about distinguishing melasma from other skin conditions
Patches that don’t respond to over-the-counter treatments

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Causes

Increased melanin production by melanocytes
Sun exposure triggering excess pigment production
Hormonal changes from pregnancy
Oral contraceptives containing estrogen and progesterone
Hormone replacement therapy
Thyroid dysfunction
Stress and elevated cortisol levels
Blue light exposure from screens

How We Can Help

We offer several approaches to help manage this condition: Melasma Treatment and Laser Treatment.

Prognosis

Melasma from pregnancy often fades after delivery
Melasma from hormones may fade after stopping the medication
Chronic melasma requires ongoing management
Treatments can fade discoloration but may not eliminate it completely
Condition commonly recurs with sun exposure
Earlier treatment typically yields better results

Frequently Asked Questions

What is melasma?

Melasma is a common skin condition causing brown or gray-brown patches, usually on the face. It occurs when melanocytes overproduce pigment. Often called the “mask of pregnancy,” it affects the cheeks, forehead, nose, chin, and upper lip. While harmless, the patches can be cosmetically distressing.

What causes melasma?

Melasma is triggered by factors that stimulate melanin production. Common causes include sun exposure, hormonal changes from pregnancy or birth control, hormone therapy, and genetics (33-50% have family history). Stress, thyroid problems, and even blue light from screens may contribute.

When should I see a dermatologist about melasma?

See a dermatologist if facial discoloration bothers you cosmetically, you want treatment options, or over-the-counter products haven’t helped. Earlier treatment often yields better results. A dermatologist can confirm the diagnosis and create a personalized treatment plan.

How is melasma treated?

Treatment starts with strict sun protection using SPF 30+ daily. Prescription options include hydroquinone, triple combination cream (tretinoin, steroid, hydroquinone), azelaic acid, and kojic acid. Chemical peels and specific laser treatments may help some patients. Treatments fade discoloration but ongoing management is usually needed.

Is melasma permanent?

Melasma from pregnancy or medications may fade once the trigger is removed. However, chronic melasma often requires ongoing management. While treatments can significantly fade patches, they typically cannot eliminate melasma permanently. Sun exposure commonly triggers recurrence.

How can I prevent melasma from getting worse?

Strict sun protection is essential. Use broad-spectrum SPF 30+ sunscreen daily, reapply every two hours outdoors, wear wide-brimmed hats, and seek shade. Avoid tanning beds and consider protective clothing. Consistency with sun protection helps prevent darkening and improves treatment results.

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