Conditions · FAQ
What causes melasma, and why can it keep coming back?
Short answer
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.
Melasma does not have one single cause. It develops when pigment-making cells become more active. Sunlight is a major trigger. Visible light, including light from the sun, can also worsen patches, especially in people with darker skin tones. A family history may increase your chance of developing melasma.
Hormone changes during pregnancy can trigger melasma. Birth control pills and other hormone treatments may also play a role. However, having melasma does not automatically mean you have a hormone disorder or need hormone testing.
Melasma can return because treatment does not remove your skin's tendency to make extra pigment. Patches may darken again after sun exposure or changes in hormones. Results vary. This is why daily sun protection matters even when patches look lighter.
Tell your physician when the patches started and whether they appeared around a pregnancy or medication change. Do not stop birth control or another prescribed medicine on your own. Your physician can discuss possible triggers and decide whether a medication review is needed.
Sources
Written by the Verra clinical team · Medical review pending
General information, not medical advice. If you're in crisis, call or text 988.