Is melasma a medical condition?

What does being a medical condition mean?

Pigmentation means skin coloring. Melanin is the pigment that gives skin its color; in melasma, the cells that make it become more active and produce excess pigment in certain areas. Although melasma is not physically harmful, changes in appearance can cause emotional distress and affect quality of life. Wanting help with those changes is a valid reason to seek treatment.134

How do you know the patches are melasma?

Melasma commonly appears as flat brown or grayish patches on the cheeks, forehead, nose, chin or above the upper lip, typically on both sides of the face. Less commonly, it affects the neck or arms. Other conditions can look similar, so appearance alone is not enough to diagnose yourself. A dermatologist usually recognizes melasma by examining the skin; occasionally, a small skin sample is needed to exclude another condition.25

Does melasma mean something else is wrong?

The exact cause is not known. Sun exposure, pregnancy and hormonal medicines, including birth control pills and hormone replacement therapy, can contribute. Rarely, other medical problems affecting hormones, such as thyroid problems, are involved. A dermatologist can review your medical history and medicines to identify likely triggers. Discuss any suspected medicine trigger with your prescriber before changing treatment.24

Melasma is more common in women and people with medium to dark skin tones, but men can develop it too. Pregnancy is one possible trigger, not the only setting in which melasma occurs.45

What can you do now?

1. 1Start with daily sun protection. Choose a tinted, water resistant sunscreen with broad spectrum protection, SPF 30 or higher and iron oxide for added protection against visible light.
2. 2Apply sunscreen to exposed skin 15 minutes before going outside. Reapply at least every two hours outdoors and after swimming or sweating.
3. 3Add shade, a wide brimmed hat and UV protective sunglasses. Avoid tanning beds and sunlamps, which can worsen melasma.
4. 4Use gentle, fragrance free skincare. Stop using products that burn or sting because irritation can darken the patches.

Visible light can pass through windows and contribute to flares while driving or sitting beside a window. Protection is relevant even when you are not standing outdoors.1

Makeup can conceal uneven color while treatment takes time, giving the cosmetics drawer a more practical assignment than collecting nearly identical shades.6

Does melasma need medical treatment?

If the discoloration bothers you or persists, a dermatologist can offer prescription creams and, in selected cases, procedures. Options include hydroquinone, azelaic acid and combinations containing a retinoid. Treatment needs supervision: irritation can worsen pigmentation, and some treatments can lighten skin too much. Peels and lasers are not reliably effective for everyone and can also worsen pigmentation.1246

During pregnancy, avoid hydroquinone and retinoid creams. Rather than starting a pigment treatment yourself, wait until after delivery or discuss a suitable option with your clinician. Pregnancy related melasma sometimes fades a few months after birth.25

Improvement can take months, and some patches remain despite treatment. There is no permanent cure; melasma can last for years and return after treatment stops. Continued sun protection helps maintain improvement.1245

For more coverage, skin camouflage uses a thick colored cream matched to your skin tone and is relatively difficult to remove, so its job description includes staying for the closing credits. A healthcare professional can help you find a camouflage service.2