Pigment Disorders
Melasma
Chloasma; "mask of pregnancy"
Common, especially in women
No — you cannot catch it or spread it
Manageable; tends to recur with sun/hormones
What Is It?
Melasma is a common condition that causes brown or grey-brown patches, usually on the cheeks, forehead, nose, and upper lip. It's most common in women and often linked to hormones and sun exposure. It is harmless but can be persistent and tends to come back, especially with sun.
Signs & Symptoms
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Brown or grey-brown patches on the face
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Usually symmetric on cheeks, forehead, nose, upper lip
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More noticeable after sun exposure
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Flat patches (no bumps or scale)
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Often worsens in summer and fades somewhat in winter
Why Does It Happen?
Melasma develops when pigment-producing cells make too much color, driven by a mix of sun (UV and visible light), hormones (pregnancy, birth control), and genetics. Heat can also play a role. Because sunlight and hormones are central, strict sun protection is the foundation of both treatment and prevention. It is NOT contagious.
Treatment Options
Sun protection is essential and comes first. Lightening creams and in-office treatments can help, but melasma often recurs, so ongoing prevention matters.
SUN PROTECTION
Daily broad-spectrum (tinted/mineral) SPF is the cornerstone.
LIGHTENING CREAMS
Hydroquinone or combination creams to fade pigment.
OTHER TOPICALS
Azelaic acid, tranexamic acid, or retinoids as alternatives or add-ons.
PROCEDURES
Careful chemical peels or lasers, used cautiously to avoid worsening.
Tips for Managing It at Home
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Use tinted mineral sunscreen daily and reapply; wear a wide-brimmed hat
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Protect from visible light (screens, sun) — not just UV
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Be gentle; harsh products and heat can worsen melasma
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Expect slow improvement and possible recurrence with sun/hormones
When to Call Your Provider
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Patches change quickly, darken unevenly, or look unusual
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Irritation or worsening from a treatment
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Melasma significantly affecting your confidence
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You're unsure whether a facial patch is melasma
Sources & further reading
The information in this handout is based on general dermatology guidance from the reputable organizations below. These links are provided for patients who wish to read more from trusted sources.
American Academy of Dermatology (AAD). Melasma: Overview. https://www.aad.org/public/diseases/a-z/melasma-overview
Canadian Dermatology Association (CDA). Photoaging. https://dermatology.ca/public-patients/diseases-conditions/skin-conditions/photoaging/
DermNet. Melasma. https://dermnetnz.org/topics/melasma
MSD/Merck Manual. Melasma. https://www.msdmanuals.com/professional/dermatologic-disorders/pigmentation-disorders/melasma
This handout is for general education and does not replace advice from your own provider. Always follow your provider’s specific instructions.
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