What is Melasma?

Melasma, also known as chloasma or mask of pregnancy, is a condition in which brown patches show up on the skin — usually on the upper lip, forehead, or cheekbones. The lower cheeks, chin, nose, sides of the neck, or any other sun-exposed areas of the face may also be affected.

Most often, melasma is seen in young women who are pregnant or taking birth control pills (hence the name “mask of pregnancy”), or women going through menopause. Hormonal imbalances or ovarian disorders may also trigger the development of melasma. Many cases also show the development of melasma without any of these predisposing factors, and it is even seen occasionally in men.

Persons who have skin tones ranging from light olive to very dark olive are particularly susceptible to melasma. The genetic factors that contribute to this tendency are not yet completely understood, but it is known that estrogen is not completely essential to the development of melasma, as men are also affected. Exposure to sunlight in the form of ultraviolet A (UVA) and ultraviolet B (UVB) is believed to be a large factor contributing to the formation of melasma in predisposed persons.

One or more layers of the skin may be affected by the pigmentation of melasma. It may be present solely in the surface layer, the epidermis, or it may be confined to the dermis, or inner layer of skin. It is usually observed in a greater or lesser degree in both outer layers of skin. The treatment of melasma is important as the pigmentation may affect both the skin’s surface layer, as well as deeper within the skin.

As it is impossible to alter the genetic tendency towards melasma, and often not practical to alter hormonal influences, complete sun protection, including the use of broad-spectrum sunscreens, protective hats and clothing, and the avoidance of the sun within practical limits, is the most effective way to avoid melasma. Treatments are based on the idea of total sun protection and the use of products designed to decrease pigmentation within the surface skin layer.

If you have a predisposition to be affected by melasma, don’t worry — most people obtain very satisfying results with the combination of appropriate topical therapy, the use of sunscreen or hats when exposed to the sun, and reduction of time spent in direct sunlight.