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Melasma is a common skin problem. The condition causes dark, discolored patches on your skin.
It’s also called chloasma, or the "mask of pregnancy," when it occurs in pregnant women. The condition is much more common in women than men, though men can get it too. According to the American Academy of Dermatology, 90 percent of people who develop melasma are women.
Melasma causes patches of discoloration. The patches are darker than your typical skin color. It typically occurs on the face and is symmetrical, with matching marks on both sides of your face. Other areas of your body that are often exposed to sun can also develop melasma.
Brownish colored patches usually appear on the:
It can also occur on the neck and forearms. The skin discoloration doesn't do any physical harm, but you may feel self-conscious about the way it looks.
If you notice these symptoms of melasma, see your doctor. Your doctor might refer you to a dermatologist, who is a doctor that specializes in treating skin disorders.
It isn’t totally clear what causes melasma. Darker skinned individuals are more at risk than fair skinned individuals. Estrogen and progesterone sensitivity are also associated with the condition. This means birth control pills, pregnancy, and hormone therapy can all trigger melasma. Stress and thyroid disease have also been postulated to be causes of melasma.
Sun exposure can also cause melasma because the ultraviolet rays affect the cells that control pigment (melanocytes).
A visual exam of the affected area is often enough to diagnose melasma. To rule out specific causes, your doctor might also perform some tests.
One testing technique is a Wood’s lamp examination . This is a special kind of light that’s held up to your skin and allows the doctor to check for infections and determine how many layers of skin the melasma affects. To check for any serious skin conditions, your doctor might also perform a biopsy. This involves removing a small piece of the affected skin for testing.
For some women, melasma disappears on its own. This typically occurs when it’s caused by pregnancy or birth control pills.
There are creams your doctor can prescribe that can lighten the skin. Your doctor might also prescribe topical steroids to help lighten the affected areas. If these don't work, chemical peels, dermabrasion, and microdermabrasion are possible options. These treatments strip away the top layers of skin and may help lighten dark patches.
These procedures don't guarantee that the melasma won't come back, and some cases of melasma cannot be completely lightened. You might have to return for follow-up visits and follow certain skin treatment guidelines to reduce the risk of the melasma returning. These include minimizing your sun exposure and wearing sunscreen.
While not all cases of melasma will clear up with treatment, there are things you can do to make sure the condition doesn’t get worse and to minimize appearance of the discoloration. These include:
Wearing protective clothing is especially important if you'll be in the sun for an extended period of time.
If you’re self-conscious about your melasma, talk with your doctor about local support groups or counselors. Meeting other people with the condition or talking with someone can make you feel better.
Written by: Jaime Herndon
Medically reviewed on: Dec 21, 2015: Steven Kim, MD
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