Melasma
Also known as: Chloasma, Mask of Pregnancy, Melasma on Breast
Brown or gray-brown facial patches triggered by hormones and sun. Extremely common in women during pregnancy or on birth control.
What to look for
Side-by-side comparison
Normal face
Even tone
Melasma
Symmetrical brown patches
Melasma is a common pigmentation disorder causing symmetrical brown or grayish-brown patches on the face, most often on the cheeks, forehead, bridge of the nose, upper lip, and chin. It affects an estimated 5 million Americans, predominantly women.
The condition is driven by a combination of hormonal factors and UV exposure. Pregnancy (chloasma or "mask of pregnancy"), oral contraceptives, and hormone replacement therapy are major triggers. UV light stimulates melanocytes in predisposed skin to produce excess pigment.
Melasma is classified by depth: epidermal (brown, well-defined - responds best to treatment), dermal (blue-gray, less defined - harder to treat), and mixed (most common).
Treatment requires a multi-pronged approach: strict daily broad-spectrum sunscreen (SPF 30+, reapplied every 2 hours in sun), topical depigmenting agents (hydroquinone, azelaic acid, tranexamic acid, retinoids, vitamin C), and sometimes chemical peels or laser therapy. Melasma often recurs with sun exposure or hormonal changes, making ongoing maintenance essential.
Quick self-check
Does this look like melasma? Answer 2 questions.
Are there symmetrical brown patches on both sides of the face?
Did it start or worsen during pregnancy, birth control, or with sun exposure?
Risk factors
- Female sex (90% of cases)
- Pregnancy
- Oral contraceptives or hormone replacement therapy
- Darker skin tones (Fitzpatrick III-V)
- Sun exposure (primary trigger)
- Family history (genetic predisposition)
When to see a dermatologist
- ⚠Symmetrical brown patches on the face that concern you
- ⚠Pigmentation that worsened during pregnancy or with birth control
- ⚠To discuss treatment options and rule out other pigmentary conditions
Often confused with
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Full ABCDE check →Frequently asked questions
Will melasma from pregnancy go away?
Pregnancy-related melasma often fades significantly within several months after delivery. However, it may not resolve completely and can recur with subsequent pregnancies or sun exposure. Consistent sun protection helps.
Can melasma be permanently cured?
Melasma is manageable but tends to recur. Even after successful treatment, it can return with sun exposure or hormonal changes. Ongoing sunscreen use and maintenance treatment are typically needed.