Melasma

Melasma is a skin condition that causes flat brown or gray-brown patches, often on the cheeks, forehead, nose, or upper lip. It usually appears on both sides of the face. It is not contagious, but a clinician should check new or changing patches rather than assuming they are melasma.

Melasma is linked to sunlight, visible light, hormone changes, and family history. Pregnancy and some hormonal medicines can trigger it. Even after patches fade, light exposure or hormone changes may bring them back. Results vary. Ongoing sun protection is important, and treatment does not remove every underlying trigger.

For melasma, choose a broad-spectrum sunscreen with SPF 30 or higher. A tinted sunscreen with iron oxides adds protection against visible light, which can worsen patches. Use it daily with shade and a wide-brimmed hat. Sun protection may help limit darkening, but it will not erase melasma. Results vary.

Prescription options for melasma may include hydroquinone, tretinoin, azelaic acid, or certain combination creams. A licensed physician in your state decides which, if any, fits your skin and health history. These treatments may gradually lighten patches, but they do not cure melasma. Results vary. Daily sun protection remains important.

Melasma treatment usually takes months rather than days, and some people notice little improvement. Results vary. The timing depends on your pigment pattern, treatment, skin tolerance, and light exposure. Follow your prescribed plan and arrange follow-up instead of using more cream to try to speed up fading.

Melasma creams can cause burning, redness, dryness, itching, or peeling. Risks depend on the ingredients and how long you use them. Some medicines can cause unwanted skin color changes or skin thinning. Stop the product and contact your physician for severe irritation, blistering, or new darkening of treated skin.

Melasma treatment during pregnancy or breastfeeding needs a medication review. Daily sun protection is a useful starting point. Topical retinoids such as tretinoin should be avoided during pregnancy, and hydroquinone is generally avoided. Tell your physician if you are pregnant, planning pregnancy, or breastfeeding before starting any lightening cream.

Some skin products can be used with melasma treatment, but combining retinol, exfoliating acids, scrubs, or other lightening products can cause extra irritation. Give your physician a complete product list before you start. Use a gentle cleanser, moisturizer, and sunscreen unless your prescribed plan says otherwise. Do not double up on ingredients.

Chemical peels and lasers may help selected people with melasma, but they can also cause burns, darker patches, or a return of pigment. Results vary. These are not first steps for everyone. An in-person dermatologist should assess your skin tone, current treatment, and risk of pigment changes before a procedure.

Melasma may be evaluated through an online or video visit, but not every patch can be diagnosed remotely. A licensed physician in your state reviews your history and decides whether treatment is appropriate. Clear photos may help. Unusual, changing, painful, or bleeding spots may need an in-person skin exam instead.