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
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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.
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:
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, especially if the pigment is deeper. Talk with your doctor about the best treatment plan for you.
Factors that are causing the melasma may be removed. For example:
Melasma can reappear and become darker if you become pregnant again or resume taking medication.
Avoid using products that irritate your skin. These include make-up, creams, and cleansers.
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.
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 remove outer layers of the skin. These include:
American Academy of Dermatology
Family Doctor—American Academy of Family Physicians
Canadian Dermatology Association
Public Health Agency of Canada
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 May 10, 2016.
Melasma. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/melasma.html. Updated April 2014. Accessed May 10, 2016.
Melasma. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=Melasma. Accessed May 10, 2016.
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 Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114465/Treatments-of-common-complaints-in-pregnant-women. Updated February 1, 2016. Accessed May 10, 2016.
Last reviewed June 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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