Blog, Skin Conditions, Skin Treatments

Melasma Causes, Symptoms, and Treatment

melasma causes

About 5 million Americans currently suffer from melasma. Of that number, 90 percent are women. Melasma is a common skin condition that causes dark, discolored patches on the skin. Melasma causes can vary.

It is more common in those who are of Latin or Asian descent and frequently affects people of Middle Eastern, African American, North African and Meditteranean descent. If you have a family member with melasma, you are more likely to develop melasma patches- regardless of your sex or ethnicity.

Melasma Causes and Triggers

Sunlit face. The cause of melasma is not understood completely. Scientists have theorized that the melanocytes, which are the skin’s color-producing cells, make too much color.

Overproduction from melanocytes could be in response to estrogen circulating in the body. And an estrogen response may be why more women suffer from it.

Melanocytes also likely indicate why people with darker pigmented skin are more susceptible to melasma. They have more active melanocytes than those with fair skin tones.

Though melasma causes are difficult to pin down, many triggers are easy to manage.

Several factors trigger melasma, including:

  • Sun exposure, which stimulates melanocyte activity
  • Hormonal changes, especially those associated with pregnancy, birth control pills or hormone replacement
  • Certain skin care products or procedures, which can irritate skin and worsen melasma patches

Melasma Symptoms

Melasma doesn’t cause pain, burning or itching. But that doesn’t mean it’s not a problem. Its symptoms are usually very visible and can cause quite a bit of distress.

Melasma is characterized by discolored patches, which might be brown, gray or gray-brown, on the:

  • Forehead
  • Nose
  • Cheeks
  • Upper lip
  • Chin

Patches of melasma can also appear on the neck or forearms. The patches may be uniform in color, or they may have a speckled or splotchy pattern.

To diagnose melasma, your dermatologist will look at your patches. Additionally in some cases, the dermatologist might need to take a biopsy to rule out other more serious problems. A dermatologist can perform skin biopsies right in the office.

Melasma Treatments

While melasma can fade on its own once any causes or triggers have been addressed or eliminated, some cases persist for years. If your melasma still bothers you, talk to your dermatologist about possible treatments options.


Lotion skin treatment.Melasma is commonly treated with hydroquinone. This medication, which is available as cream, works by lightening the skin.


Mild hydroquinone treatments are available over-the-counter, but stronger formulations are available through prescription medical grade skin care products and can lighten your patches faster.

In some cases, products or regimens with other active ingredients are also recommended alongside hydroquinone. These ingredients can enhance skin lightening.


Medication is effective for many people, but it might not be enough for everyone. Dermatological procedures offer an alternative.

Common procedures used in the fight against melasma include:

  • Chemical peels, which can penetrate the skin and lighten or eliminate the discoloration
  • Laser and light-based treatments, which stimulate your own physiological processes to reduce melasma patches
  • Microneedling, which can allow skin lightening treatments to penetrate deeply to eliminate melasma at its source

A dermatologist should perform these procedures to ensure that specific patient’s skin types receive the right treatment.

Additionally, many products or procedures can make melasma worse, so it is VERY important that an experienced board certified dermatologist that is knowledgable about the condition and treatment options performs any treatments.

Maintenance Therapy

There is no cure for melasma. Dermatologists typically recommend maintenance therapy once it fades. The design of your maintenance therapy will prevent your melasma from returning.

You’ll need to limit your sun exposure, wear the right sunscreen and use the correct products for your skin type. You will also need to avoid waxing, which can cause inflammation and worsen existing melasma.


Woman smiling.Melasma causes cannot be prevented. However, with appropriate care, people with melasma can enjoy clearer, more evenly colored skin. Though it can take months for the patches to fully fade.

You’ll also need to follow your dermatolgist’s advice regarding other medications, sun exposure and skin care products to reduce triggering irritation and new patches.

Melasma might not cause any serious physical problems, but it can affect your self-confidence. Whether you have one small patch or many, we can help. Call our dermatology office today to schedule your consultation.