Melasma: Causes, Symptoms, Pictures & Treatment

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Medical News TodaySubscribeWhat to know about melasma

Medically reviewed by Megan Slomka, MSN, APRN, FNP-C — Written by Jenna Fletcher — Updated on February 28, 2025

What is it?
Pictures
Symptoms
Causes
Diagnosis
Treatment
Prevention
Summary

Melasma is a common skin condition that causes patches of darker skin to form, often on the face. It tends to occur in areas with more sun exposure.

Melasma is not harmful, but it may affect how a person feels about their appearance. The conditions occurs more often in females than males, and it can appear during hormonal changes, such as pregnancy.

Read on to learn more about melasma, including the symptoms and treatments.

Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. Learn more.

What is melasma?

Melasma is the medical term for patches of skin that are darker than a person’s usual skin tone. It is a type of hyperpigmentation.

Between 1.5% to 33% of all people may have melasma, depending on the population. According to the American Academy of Dermatology, only 10% of all cases of melasma occur in males.

Females and those who are pregnant are more likely to develop melasma. Taking certain medications can also contribute.

Appearance and pictures

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This image shows melasma on the cheeks. Photography by Yuuurin/Getty Images

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This image shows melasma on the face. Photography by DermNet New Zealand

Symptoms of melasma

The main symptom of melasma is areas of darkened skin, or hyperpigmentation. These patches are typically flat and appear darker than an individual’s skin tone. They may be brown or gray in color.

The melasma may develop in one specific place with defined edges, or it may be more diffuse across the skin. It will typically appear on areas that get sunlight exposure, such as the face.

Some common places where melasma can develop include:

the bridge of the nose
the forehead
the cheeks
the upper lip
the chin

Melasma may also appear on other areas of the body, such as the neck, forearms, or legs.

The condition does not cause pain and is not harmful, but people can find the appearance of these patches bothersome. They may affect a person’s self-image or self-esteem, in some cases.

It is important to note that melasma is not a form of skin cancer, though it may sometimes look like other skin conditions. If melasma has appeared for the first time, or it changes in appearance, consult a dermatologist.

Melasma causes and risk factors

Doctors do not fully understand why melasma occurs. It may be due to the malfunction of the melanocytes, which are cells in the skin that produce melanin. They may produce too much, causing patches of darker skin.

People with medium to darker skin tones may be more likely to develop melasma because they have more melanocytes than people with lighter skin do.

Other risk factors include:

UV light exposure: Frequent exposure to UV rays can trigger melasma. This can come from the sun, as well as tanning beds and UV lamps.
Skin tone: Melasma occurs most commonly in people with light brown skin tones, particularly if they live in areas with high levels of sun exposure.
Sex: Melasma affects females about 9 times more than it does males.
Pregnancy: Melasma is more common during pregnancy, affecting 15% to 50% of pregnant people. This may be due to pregnancy hormones.
Genetics: Up to 50% of people with melasma report that close relatives also have the condition, suggesting a genetic link.

Other triggers for melasma can include:

hormonal changes during pregnancy (chloasma) or while taking hormone therapy
irritation from certain skin care products
some medications, including:
- anti-seizure medications
- retinoids
- some blood pressure medications
- certain antibiotics

Diagnosing melasma

Dermatologists typically diagnose melasma during a visual examination of the skin. They may also use a special lamp, such as a Wood’s light, to see areas of hyerpigmentation more clearly.

Since melasma can resemble other skin conditions, a dermatologist may take a small biopsy, or sample, to send to a laboratory for analysis. This may help rule out other conditions.

Treatment of melasma

Treatment is not always necessary for melasma. It is not harmful, and sometimes it fades away on its own.

If pregnancy or medications have caused melasma, it may go away after giving birth or discontinuing the medication.

But if melasma does not fade over time and a person wishes to treat it, there may be ways to fade the darker patches.

However, not all treatments work for everyone, and melasma can sometimes come back even after treatment.

A dermatologist may suggest:

Hydroquinone

Doctors often use hydroquinone as the first line of treatment for melasma. Hydroquinone is available as a lotion, cream, or gel. It works by lightening the color of the skin patches.

A person can apply the hydroquinone product directly to the patches of skin that are discolored or uneven.

Hydroquinone is available as a prescription.

Corticosteroids and tretinoin

Mild corticosteroids and tretinoin come in creams, lotions, or gels. Both corticosteroids and tretinoin can help lighten the color of the melasma patches.

Combined creams

In some cases, a dermatologist may choose to prescribe combination creams that may contain hydroquinone, corticosteroids, and tretinoin in one. These are called triple creams.

Additional topical medications

In addition to or instead of other medicated creams, a dermatologist may also prescribe azelaic acid or kojic acid. These acids work to lighten the dark areas of skin.

Medical procedures

If topical medications do not work, a dermatologist may recommend procedures such as:

microdermabrasion
chemical peel
laser treatments
dermabrasion

Some of these treatment options have side effects or may cause additional skin problems. It is best to speak with a doctor or dermatologist about possible risks.

»MORE:Get a skin condition evaluation in as little as 15 minutes with Optum Now Online Care.

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Preventing melasma

If a person has had melasma before, they can try to avoid triggers by:

limiting sun exposure
applying sunscreen every day before going outside
wearing a hat when in the sun

Learn more about protecting the skin from the sun.

Summary

Melasma refers to darker patches of skin. It is a common condition, and occurs more often in females than males.

While it is harmless, some people may find melasma bothersome. Treatment is effective for some people. Melasma that is due to hormonal changes may also fade over time, once hormone levels return to normal.

Taking steps to limit sun exposure such as wearing a hat and sunscreen may help prevent melasma.

Dermatology
Birth Control / Contraception
Cosmetic Medicine / Plastic Surgery
Women's Health / Gynecology
Skin Care
Skin Conditions

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Basit H, et al. (2023). Melasma.https://www.ncbi.nlm.nih.gov/books/NBK459271/
Melasma. (n.d.).https://www.asds.net/Skin-Experts/Skin-Conditions/Melasma
Melasma: Overview. (2022).https://www.aad.org/public/diseases/a-z/melasma-overview
Pandya AG. (n.d.). Melasma.https://skinofcolorsociety.org/discover-patients-public/patient-education/melasma

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Medically reviewed by Megan Slomka, MSN, APRN, FNP-C — Written by Jenna Fletcher — Updated on February 28, 2025

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