What Is Melasma?
Melasma is a common condition causing brown to gray-brown patches, most often on the face — typically the cheeks, forehead, bridge of the nose, and upper lip — usually in a fairly symmetric pattern on both sides.
It's strongly linked to hormonal factors (pregnancy, birth control, hormone therapy) and is significantly worsened by sun and even visible light exposure, which is why sun protection is central to both treating and preventing melasma. It's more common in women and in people with darker skin tones.
Causes
- Hormonal changes — pregnancy ('the mask of pregnancy'), birth control pills, and hormone therapy are common triggers
- UV and visible light exposure, which significantly worsens and can trigger melasma
- Genetic predisposition — melasma often runs in families
- Certain medications and, in some cases, thyroid conditions
Symptoms
- Symmetric brown or gray-brown patches, most often on the cheeks, forehead, nose, or upper lip
- Patches that darken with sun exposure and can fade somewhat without it
- No itching, pain, or texture change — melasma is purely a pigmentation change
- A tendency to persist or recur, especially without consistent sun protection
Treatment Options at Dermatology of Seattle
- Topical prescription treatment combinations tailored to melasma specifically
- Chemical peels to help fade stubborn pigmentation
- Careful, dermatologist-guided use of light-based treatments in appropriate cases
- A strict daily sun protection routine, which is essential to both treatment success and preventing relapse
When to See a Dermatologist
See a dermatologist for a proper diagnosis if you notice new symmetric facial patches, since melasma responds best to a structured, dermatologist-guided treatment plan rather than over-the-counter products alone. Because melasma is prone to recurrence, ongoing dermatology follow-up is often part of long-term management.
Frequently Asked Questions
Will melasma go away after pregnancy?
For many women, pregnancy-related melasma fades significantly after delivery as hormones return to baseline, though it doesn't always resolve completely on its own, and sun exposure can keep it active.
Why does my melasma keep coming back?
Melasma is notoriously prone to recurrence, especially with sun or even bright indoor light exposure. Consistent, year-round sun protection — not just during active treatment — is essential to keeping it from returning.
Are over-the-counter brightening products enough to treat melasma?
Over-the-counter products can offer mild improvement, but melasma typically responds much better to prescription-strength, dermatologist-guided treatment combined with strict sun protection than to over-the-counter options alone.