Melasma

Also known as: Chloasma, Mask of pregnancy, Melanoderma, Facial pigmentation

Melasma is a common condition causing symmetric brown to grayish patches on the face, often triggered by sun and hormones.

Signs & Symptoms

  • Symmetric brown patches
  • Gray-brown discoloration
  • Typically on cheeks, nose, forehead
  • Equal distribution bilaterally
  • No itching or scaliness

Causes

  • Excessive sun exposure (prime trigger)
  • Hormonal changes (pregnancy, hormonal medications)
  • Genetic predisposition
  • Skin inflammation
  • Use of phototoxic products

Risk Factors

  • Female gender
  • Darker skin types (Fitzpatrick III-V)
  • Age 20-60 years
  • Living in sunny climates
  • Pregnancy and oral contraceptives

When to See a Doctor

See a dermatologist if you have symmetric facial brown patches, especially if worsening. Early intervention prevents deepening.

Treatment Options

Treatment options vary by individual. Consult a dermatologist for a personalised plan.

  • Strict sunscreen use (SPF 50+)
  • Topical depigmenting agents
  • Chemical peels
  • Laser therapy (Q-switched, picosecond)
  • Combination therapy

Understanding Melasma

Melasma is a common skin condition characterized by symmetric patches of hyperpigmentation, typically on the cheeks, bridge of nose, forehead, or upper lip. It affects an estimated 5-14% of the global population, with higher prevalence in darker skin types.

Characteristics

  • Symmetric distribution
  • Sharply demarcated borders
  • Brown to gray-brown color
  • Non-inflammatory (no itching or scaliness)
  • Usually on face, occasionally neck and forearms

Root Causes

Primary Triggers

Sun Exposure: Ultraviolet radiation is the primary trigger, stimulating melanocytes to produce excess melanin.

Hormonal Factors: Estrogen and progesterone increase melanin production, triggered by pregnancy or oral contraceptives.

Genetic Predisposition: More prevalent in certain ethnic groups.

Secondary Contributors

  • Specific medications (antimalarials, tetracyclines)
  • Cosmetic products containing irritants
  • Thyroid disorders
  • Genetic polymorphisms affecting melanin regulation

Types of Melasma

Epidermal: Melanin in upper skin layers; darker, responds better to treatment

Dermal: Melanin deposited deeper; grayish, difficult to treat

Mixed: Combination of epidermal and dermal; most common

Prevention Strategies

Sun Protection:

  • Use SPF 50+ daily, reapply every 2 hours
  • Wear protective clothing and wide-brimmed hats
  • Avoid peak sun hours (10 AM - 4 PM)

Hormonal Management:

  • Discuss alternatives to hormonal medications with your physician
  • Consider alternatives during high-risk periods

Skincare:

  • Use gentle, non-irritating products
  • Avoid known phototoxic substances
  • Maintain consistent regimen

“When to see a doctor”: If plaques are new, changing rapidly, or accompanied by symptoms, professional evaluation is important.

Available Treatments

Professional treatments show better results than home care alone. We customize treatment plans based on melasma type and individual factors.

Schedule your melasma consultation today for personalized evaluation and treatment plan.

Medically reviewed by Dr. Sanjay Agrawal, MBBS, MD (Dermatology) —

Have this condition?

Call the clinic or visit Dr. Sanjay Agrawal directly for a proper diagnosis and personalised treatment plan.

FAQs about Melasma

Why did I develop melasma?
Combination of genetic predisposition, sun exposure, and often hormonal factors (pregnancy, oral contraceptives). It's not caused by infection or poor hygiene.
Is melasma dangerous?
Melasma is purely cosmetic and not harmful to health. However, it indicates significant sun exposure or hormonal influence.
Can melasma be prevented?
Daily SPF 50+ sunscreen use is first-line prevention. Avoiding hormonal triggers and protective clothing also help.
Is melasma permanent?
Without treatment and sun protection, melasma typically persists. With proper therapy and prevention, significant improvement is achievable.
Does bleaching cream work?
Topical depigmenting agents reduce pigmentation gradually over months. Results are modest alone but better in combination with other therapies.
Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice. Consult a qualified dermatologist for diagnosis and treatment. Individual results vary.
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