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What is Melasma?  

Melasma is a chronic skin condition that causes dark, gray-brown patches to appear on the skin. It’s commonly associated with sun damage as too much sunlight exposure can cause the skin to produce more pigment and darken the facial skin. 

Some cases of melasma can be mistaken for freckles as it can also form small spots on the skin. However, melasma patches are typically larger than the usual sun spots, freckles, and age spots. 

Women are more likely to develop patches of skin discoloration than men. Melasma is also thought to be linked to hormonal changes and can often occur in pregnant women. This skin condition is sometimes called ‘the mask of pregnancy’.  

What Causes Melasma? 

Melasma is related to the melanocytes or the pigment-producing cells in the skin. Melanocytes are found in the basal cell layer at the epidermis and they are mainly responsible for creating melanin that gives the skin its color. 

It’s highly likely that dark patches of melasma appear when the melanocytes are stimulated and produce too much pigment. There are several factors that can contribute to the overproduction of these skin cells like 

Sun exposure - The ultraviolet light from the sun can cause the skin to produce more melanocytes and worsen the existing symptoms of melasma. 

Hormone changes - Pregnancy can cause hormone fluctuations and the increased levels of estrogen and progesterone can influence melanin production. Additionally, taking birth control pills and hormone replacement therapy can lead to melasma. 

Use of certain skincare products - Some cosmetic or skincare products can irritate your skin and cause discoloration or phototoxic reaction (similar to a sunburn or rash).  

Tanning beds - The UV light from tanning beds can be just as damaging to your skin as frequent sun exposure. 

LED Light - Blue lights from bulbs, computer screens, television, and other electronic devices can likewise cause melasma.

Scented soaps and fragrances - The use of deodorant soaps, scented fragrances, and other cosmetics may also trigger melasma symptoms.  

What is the treatment for Melasma? 

Medication and procedures: Your dermatologist may prescribe a medication that can decrease the excess pigment in your skin. Most patients receive a prescription for medication that they apply to their skin at home.

Your dermatologist may prescribe one or more of the following: 

Hydroquinone: This is a common treatment for melasma. It is applied to the skin and works to even out the skin tone. Hydroquinone is no longer available in products that you can buy without a prescription.

Tretinoin and a mild corticosteroid: This combination contains a retinoid and an anti-inflammatory, which can even out skin tone. 

Triple combination cream: This cream contains three medications — tretinoin (a retinoid), a corticosteroid to reduce inflammation, and hydroquinone to even out your skin tone. 

Other medications: Your dermatologist may prescribe a medication that’s gentler on your skin like azelaic acid, kojic acid, or vitamin C.

When using makeup to hide melasma, it’s important to apply everything in the right order to get the best results. Here’s the order that dermatologists recommend:

  • Melasma medication
  • Sunscreen
  • Camouflage makeup

Dr. Greenberg takes a personalized approach to develop the best treatment plan for each patient dealing with melasma. It's best to consult with Dr. Greenberg to determine the best course of treatment for your specific case.