Melasma is a common pigmentation disorder of the skin that causes patches of brown spots to appear on the face. These areas of hyperpigmentation are commonly found on the upper cheeks, forehead, upper lip, and chin and can appear darker or lighter at various times of the year. Although it can occur in men, melasma is most common in women of reproductive age, particularly those who are pregnant or have darker skin (i.e. Asian, Latin, Hispanic, Middle Eastern).
The leading causes of melasma are chronic or excessive sun exposure, hormonal fluctuations, and genetic predisposition. Melasma that appears during pregnancy is called cholasma, and is often referred to as the “mask of pregnancy”. Birth control pills or hormone replacement therapy (HRT) may also trigger the condition.
Treatment for melasma involves medical grade skincare with prescription-strength hydroquinone, along with diligent sun protection. Other treatments that may offer some benefit are customized facial peels, and laser therapy. Typically, a combination approach is most effective. Once melasma has been treated, it is essential to practice strict sun avoidance or sun protection using physical sunblock, wide-brimmed hats, and sun-protective clothing whenever possible. Any unprotected sun exposure can cause melasma to recur.