How treat melasma.

How treat melasma.

Melasma is brown, tan or grey patches on  the skin of the face and neck.

Melasma is often referred to as “pregnancy mask,” but doesn’t always develop during pregnancy

Have you noticed a patch or multiple patches of darker skin on your face?  I’m not talking freckles.   I’m talking about patches of brown, tan or sometimes even a grey hue (hyperpigmentation) that develop on your cheeks, forehead, upper lip, nose and chin.    Do these patches get darker after being in the sun?   Did you first notice these patches when you were a teenager or pregnant?   You might have developed Melasma.  Melasma (muh-LAZ-muh) is a darkening or Hyperpigmentation, of the sun exposed areas of the face.  This may look like dark patching on the face.   You can also get melasma on your chest or arms, but that is less common.    The exact cause of Melasma is not completely understood, but factors that contribute to developing Melasma are:

  1. Darker skin,
  2. UV exposure
  3. Hormonal factors (such as pregnancy or birth control pills)
  4. Medications:   Cosmetic creams anti-seizure medications might cause Melasma.
Melasma most often affects the face

Melasma affects women over men 9 out of 10 times.  Melasma can be due to hormonal changes during pregnancy, or due to sun exposure.   25% of the time, Melasma develops for a women during her pregnancy, usually during the second trimester.


If it develops during pregnancy, it is often called “the mask of pregnancy” or “pregnancy mask”.  Women who develop Melasma during pregnancy, might find that it lightens up over time.  If it does not, there are things you can do.

Melasma affects women over men 9 out of 10 times

There is not a special test needed to diagnose Melasma.  Your doctor, PA or NP can diagnose it from your history and exam alone.

Melasma, pregnancy mask. Dark skin on the face
Melasma can develop or worsen with sun exposure.


There are several types of treatments for melasma.    There is not one treatment that works for everyone, and many people need to do more than 1 treatment help.

You many need more than one treatment to make it go away.  

  1. Sun protection measures .including: Sun avoidance, (not my favorite option)  Broad Spectrum Sunscreens. Most dermatologists recommend a sun block with and SPF of 30 or higher.  Wearing a wide brimmed hat.

2.   Skin lightening cream.   Be aware that not all creams are the same and may not work the same for everyone.  You must use OTC creams cautiously, especially if you have sensitive skin.  It would be a good idea to consult your medical provider before trying anything too strong.

3.  Prescription strength skin lightening cream.   Your medical provider might prescribe you a prescription strength cream that can lighten the patches from Melasma.  There are several different types of lightening creams and your provider can choose the best one for you. There are some types of creams that are not safe during pregnancy, so tell your doctor if you could be pregnant.

4.  Chemical peels.   With this treatment, a chemical solution is applied to the face which causes the skin to blister and eventually peel off, revealing smoother skin and lighter melasma.

Melasma, pregnancy mask. skin lightning cream
Skin lightening creams can help lighten Melasma

If you don’t see a response with cream or chemical peels, your dermatologist might suggest Laser or light-based therapies.  These treatments must be done carefully and only by a dermatologist.  If done wrong, they can cause new problems or worsen Melasma.

Even after your melasma has been treated, it can return again if you are not careful. 

You can prevent Melasma from returning by:

  1. Using sun protection.   Sun block can help prevent melasma from developing or returning.  You can get sun exposure even on a cloudy day or through a window, so it’s best to apply it daily, year-round.  Choose a broad-spectrum sunscreen with an SPF of 30 or greater.  It’s best if you choose a sunscreen that contains Zink Oxide or titanium dioxide to physically limit the effects of the sun’s rays on your skin. Apply sunscreen 15 minutes before going outside and reapply at least every two hours
  2.  Wear a hat, preferable a large brimmed hat when you go in the sun.
    Melasma, pregnancy mask, sunblock, hat
    Wearing a hat and using sun block can help prevent Melasma
  1. Choose skin care products that don’t sting or burn.  Products that irritate the skin may worsen melasma.
  2. Avoiding waxing areas where Melasma is present. Waxing creates irritation that can make your melasma come back.

If you are struggling with Melasma,  you are not alone!

Bottom line is that melasma is super common, so if you are struggling with it, you are not alone.  Sun protection is the best way to prevent Melasma, or keep it from getting worse.   Grab that sunblock, hat and sunglasses every time you are in the sun and wear a face moisturizer with SPF 30 at least.   Don’t be afraid to talk to your Doctor or PA if you would like to try something a little stronger than OTC creams.  But most importantly, don’t forget you are beautiful!

Sun protection is the best way to prevent Melasma, or keep it from getting worse

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