Is melasma dangerous?

What does melasma usually look like?

Melasma causes flat brown or grayish patches, usually on both sides of the face. Common places include the cheeks, forehead, nose and above the upper lip. Melasma itself does not normally hurt or itch. The color comes from excess melanin, the pigment that gives skin its color. Sunlight and hormonal changes can contribute, which helps explain why melasma often appears during pregnancy or while taking birth control pills.1234

When should you get the patches checked?

Arrange an appointment if facial darkening does not go away or you have not had the diagnosis confirmed. Pain, itching or a raised patch does not fit the usual description of melasma, so do not assume those changes are harmless pigmentation. A dermatologist can often diagnose melasma by examining your skin. A special light or magnifying device helps assess how deep the pigment sits; occasionally, a small skin sample is needed to distinguish another condition.145

Do you have to treat melasma?

Confirmed melasma does not need treatment to protect your health, but its visibility can seriously affect quality of life. You can choose treatment if the discoloration bothers you, rather than treating your face as a compulsory renovation project, which is an oddly ambitious brief for a bathroom mirror. A treatment plan should account for your skin tone, pigment depth and possible triggers.35

What can you do each day?

1. 1If you have prescribed melasma medication, apply it as directed before sunscreen.
2. 2Apply broad spectrum SPF 30 or higher before going outdoors, including during winter. Reapply at least every two hours while in the sun. A tinted sunscreen containing iron oxides is an option for melasma.
3. 3Wear a hat with a wide brim and seek shade. Avoid midday sun when possible, along with tanning beds and sun lamps.
4. 4Apply camouflage makeup after sunscreen if you want coverage.

Camouflage makeup can hide melasma, without requiring a matching camouflage wardrobe.5

Can treatment make melasma worse?

Yes. Irritating skincare can worsen melasma, and some treatments can make pigmentation darker, particularly in darker skin tones. Chemical peels and lasers also carry a risk of worsening melasma or causing dark marks after inflammation. These procedures need expert assessment, not an automatic booking. Prescription creams are another option; dermatologists use treatments such as hydroquinone or combinations containing tretinoin and a corticosteroid. If a product irritates your skin, stop using it and discuss the reaction with your clinician.1235

What if melasma started during pregnancy?

Wait until after giving birth to start melasma treatment, while continuing sun protection. Products sold without a prescription are not automatically safe during pregnancy. Pregnancy related melasma often fades over several months after delivery. If the patches appeared while taking hormone medicines, discuss that possible trigger with the prescriber rather than changing the medication yourself.24

Will melasma go away?

Some melasma fades on its own, but it can persist for years or a lifetime. Treatment usually takes three to twelve months to show results, sometimes longer for longstanding melasma. Fading is not a permanent cure: sun exposure can bring pigmentation back. If a treatment bought without a prescription has not helped within three to six months, see a dermatologist instead of continuing indefinitely.25