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Pronounced: mah-LAZ-ma


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.

It is common during pregnancy, but can happen in men and women.

Common Site for Melasma


Melasma usually appear on the face.

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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.

Risk Factors

Factors that increase your chance of melasma include:

  • Family history of melasma
  • Being a woman of reproductive age
  • Having a darker skin tone
  • Pregnancy
  • Getting too much sun exposure
  • Taking birth control pills
  • Using products that irritate the skin, such as cosmetics
  • Taking certain medicines, such as antiseizure medicines, or hormone therapy

The only sign of melasma is dark patches of skin. It is not painful or itchy.

Not all brown patches on your skin are melasma. Talk to your doctor about changes in your skin.


Your doctor will ask 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. Talk with your doctor about the best treatment plan for you.

Removing Cause

Factors that are causing the melasma may be removed. For example:

  • Melasma associated with pregnancy may slowly fade after giving birth
  • Melasma associated with birth control pills or hormone replacement therapy may fade after the medication is stopped

It can reappear and become darker if you become pregnant again or resume taking medication.

Ultraviolet Light Protection

Protecting your skin from UV light is important in helping to fade melasma. This means avoiding sun and tanning bed exposure. Your doctor may recommend wearing sunscreen, clothing, and hats when outdoors.

Depigmenting Medications

Certain medicines, 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, like tretinoin , corticosteroids, azelaic acid or glycolic acid. These creams enhance the skin-lightening effect.

Your skin may be sensitive to these medicines. Use care and start slowly when first using them. It may take several months before you see an improvement.

Other Treatments

Other treatments remove outer layers of the skin. Examples include:

  • Chemical peel
  • Microdermabrasion—removing top layer of skin
  • Laser therapy

Along with treatment, avoid using products that can irritate your skin. These include make-up, creams, and cleansers.


To help reduce your chance of getting melasma, take the following steps:

  • Limit the amount of time you spend in the sun. Avoid using tanning booths.
  • Use sunscreen daily. Wear sunscreen that protects against both UVA and UVB rays and has an SPF of 30 or more.


The American Academy of Dermatology

American Academy of Family Physicians Family Doctor


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: . Accessed June 11, 2013.

Melasma. American Osteopathic College of Dermatology website. Available at: . Accessed June 11, 2013.

Melasma. American Academy of Family Physicians Family Doctor website. Available at: . Updated February 2011. Accessed June 11, 2013.

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 discomforts during pregnancy. EBSCO DynaMed website. Available at: . Updated April 18, 2013. Accessed June 11, 2013.

Last reviewed June 2013 by Brian Randall, 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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