What is melasma?
Melasma is a type of hyperpigmentation, where the skin makes too much melanin in certain areas. It usually appears as flat, brown or grey-brown patches with blurry edges, often on both sides of the face in a similar pattern.
Common places include:
- The cheeks
- The forehead
- The bridge of the nose
- The upper lip
- The chin
It can also appear on the forearms and neck. Melasma is much more common in women than men, and in people with medium to darker skin tones, which includes many people in India.
Melasma isn't infectious, painful or a sign of skin cancer. But because it shows on the face, it can affect how people feel about their skin.
What causes melasma?
Doctors don't know exactly why some people get melasma and others don't, but several triggers are well known:
- Sun exposure: the most important trigger. UV rays, and visible light in deeper skin tones, stimulate pigment cells and can make melasma darker or bring it back.
- Hormones: melasma often starts or worsens during pregnancy, which is why it's sometimes called "the mask of pregnancy". Birth control pills and hormone therapy can also trigger it.
- Genetics: melasma often runs in families.
- Skin irritation: harsh skincare, waxing and procedures that inflame the skin can make it worse.
- Some medicines and medical conditions: a few medicines, and some health conditions such as thyroid problems, have been linked to melasma.
- Stress: may play a part for some people.
Melasma or another type of pigmentation?
Melasma can look like other dark patches, such as sun spots or dark marks left by acne. The pattern, the way it responds to sun and hormones, and the depth of the pigment all help a dermatologist tell them apart. Getting the diagnosis right matters, because some treatments that suit other pigmentation can make melasma worse.
For other types of dark patches, see our page on pigmentation and uneven tone.
How dermatologists treat melasma
There's no permanent cure for melasma, but it can be controlled well. A dermatologist will choose treatment based on your skin, how deep the pigment is and what's triggering it. A plan may include:
- Topical treatments: prescription creams that reduce pigment, sometimes combined to work better together.
- Oral treatment: in some cases, a dermatologist may prescribe medicine taken by mouth, such as tranexamic acid, after checking it's safe for you.
- In-clinic procedures: chemical peels and some other procedures can help stubborn melasma. Lasers are used with caution, because in some people they can make melasma darker.
- Professional home care: brightening products that support treatment and help maintain results.
- Managing triggers: for example, reviewing hormonal medicines with your doctor.
Treatment usually takes a few months to show clear improvement. Because melasma often returns, most people need a long-term maintenance plan after the patches have faded.
Daily care that helps
Wear sunscreen every single day
Use a broad-spectrum sunscreen with SPF 30 or higher, rain or shine, indoors near windows too. This is the most important step.
Choose a tinted sunscreen if you can
Tinted formulas with iron oxides also protect against visible light, which matters for melasma in deeper skin tones.
Reapply when you're outdoors
Reapply about every two hours, and after sweating.
Add a hat and shade
A wide-brimmed hat and staying out of strong midday sun make a real difference.
Be gentle with your skin
Avoid scrubs, harsh products and waxing on areas with melasma.
Stick with your plan
Stopping treatment or sun protection early is one of the most common reasons melasma comes back.
