What is Melasma?

Skin Pigmentation DisorderMelasma is a common skin pigmentation disorder. It is more common in women than men and is more common in people with darker skin types. Melasma appears most commonly on the face as brownish patches, although it can occur on the neck, chest, and arms. The disorder is triggered by hormones (especially estrogen or estrogen derivatives) and is worsened by unprotected or excessive exposure to the sun.

Caring for Your Skin with Melasma

It is critically important for patients with this skin condition to keep the skin protected through the use of sunscreen and a hat when if at all possible when exposed to UV light. Melasma is commonly seen in pregnant women, hence the name “mask of pregnancy.” Some medications, such as birth control pills (especially those containing estrogen), can also contribute to melasma. As there are several different skin disorders that present with pigmentation changes, it is important that the correct diagnosis be made. A dermatologist can help with the diagnosis, in addition to providing relevant education and effective treatment strategies for this common but frustrating skin disorder.

Melasma may fade on its own over time, but unfortunately this is usually not the case. Melasma in most cases gradually becomes permanent and progressive. If or when it does become permanent, there are several effective treatments available.

Treatment Options


Hydroquinone is a topical medicine that is applied to the skin. It works by turning off the pigmentation production mechanism; thus, lightening the skin. This treatment may come as a cream, lotion, gel, or liquid. You may be able to get some products containing hydroquinone without a prescription, but they will contain less hydroquinone and often will be less stable and predictable than a product that your dermatologist can prescribe or recommend.

Tretinoin and Corticosteroids

Tretinoin and corticosteroids are topical medicines that your dermatologist may prescribe to enhance the skin lightening process. Oftentimes, your dermatologist will suggest a supplementary all-in-one cream that contains hydroquinone, tretinoin, and a corticosteroid that works better than using a cream where each ingredient is applied separately.

Other Topical Medications

Your dermatologist may prescribe other topical treatments, either alone or in combination with other treatments, such as Azelaic acid or Kojic acid to help lighten the pigmentation associated with melasma.

Cosmetic Treatments for Melasma

In most cases, melasma may be effectively improved cosmetically using various skin procedures, such as:

  • TCA chemical peeling
  • Obagi Skin Restoration Protocol
  • Lasers can be used in some cases for melasma, but special care needs to be taken as some lasers can contribute to rebound and increased pigmentation.

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