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Melasma

Melasma is patches of dark skin that appear on areas of the face exposed to the sun.

Alternative Names

Chloasma; Mask of pregnancy; Pregnancy mask

Causes, incidence, and risk factors

Melasma is a very common skin disorder. It is most common in young women with brownish skin tone, but it can affect anyone. 

Melasma is often associated with the female hormones estrogen and progesterone. It is common in:

  • Pregnant women
  • Women taking birth control pills (oral contraceptives)
  • Women taking hormone replacement therapy (HRT) during menopause.

Being in the sun makes melasma more likely to develop. The problem is more common in tropical climates.

Symptoms

The only symptom of melasma is change in skin color. However, this can cause distress about how you look. 

The skin color changes are most often an even brown color. They usually appear on the cheeks, forehead, nose, or upper lip. Dark patches are usually symmetrical (matching on both sides of the face).

Signs and tests

Your health care provider will look at your skin to diagnose the problem. A closer exam using a Wood's lamp may help guide your treatment.

Treatment

Treatments may include:

  • Creams containing a combination of tretinoin, hydroquione, kojic acid, and azelaic acid have been shown to improve the appearance of melasma.
  • Chemical peels or topical steroid creams
  • Laser treatments can be used to remove the dark pigment if problem is severe.
  • Stopping hormone medicines that may be causing the problem

Expectations (prognosis)

Melasma often fades over several months after you stop taking hormone medicines or pregnancy ends. The problem may come back in future pregnancies or use if you use these medicines again. 

Calling your health care provider

Call your health care provider if you have darkening of your face that does not go away.

Prevention

Using sunscreen every dahelps prevent melasma. Sunscreen use also helps prevent skin cancer and wrinkles.

References

Habif TP. Light-related diseases and disorders of pigmentation. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 19.

Sood A, Tomecki KJ. Pigmentary disorders. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010.

Updated: 11/20/2012

Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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