Melasma: Symptoms, Diagnosis, and Treatments

Melasma: Symptoms, Diagnosis, and Treatments
Published : Feb 04, 2024
Last Updated : Feb 06, 2024

Melasma is a skin problem in which your skin becomes patchy, tan, or blue-grey skin discolored. It is also considered as chloasma or a ‘mask of pregnancy. 

Several women during their reproductive years suffer from Melasma. However, it is found very rare in men. This skin problem is mainly related to external sun exposure & hormones like birth control pills.

As a woman, you can also suffer from Melasma when undergoing several internal hormonal changes during pregnancy. It is often noticed that 90% of people who suffer from this skin problem are women. 

Women suffering from Melasma also have a daily or irregular sun exposure history. Though it is medically harmless for various people, it is a cause of embarrassment, and they look for treatment. 

Some of the common triggers of Melasma include:

  • Skin tone
  • Increased estrogen hormones
  • Sun exposure
  • Pregnancy
  • Skin inflammation
  • Genetics
  • Certain drugs

There are also three types of Melasma epidermal, dermal, and mixed Melasma.

  • Epidermal Melasma is dark brown and also has a well-defined border. 
  • Dermal Melasma is light brown to bluish and has a blurry border.
  • Mixed Melasma is the most common, with bluish wells and brown patches. 

 Who is at risk of Melasma?

People with Fairer skin are less likely to have the risk of Melasma than those with darker brown skin or tan well. As you have read above, women are more likely to get Melasma than men. According to rough data, about 10% of men get Melasma, and almost 90% of women have to deal with it. If we talk about when it usually occurs, pregnant women get Melasma more often than any other time. A woman can also be at risk of Melasma when she takes oral contraceptives and hormones. 

Symptoms of Melasma

You must know that Melasma causes hyperpigmentation darker than your original skin color. Your skin starts looking blotchy and uneven, with uneven borders on the discolored spots. 

Remember that discoloration can be slightly dark and even highly dark than your normal skin color. As per your skin tone and the harshness of the Melasma, the discoloration can vary from light brown to black. 

It is necessary to know that Melasma occurs on the areas of your skin exposed to the sun-like face. Some other common areas include above the upper lip, across the cheeks, forehead, and nose. 

This skin problem can develop anywhere on the face, chest, upper back, and upper arms. 

One thing that you need to keep in your mind is that Melasma primarily occurs symmetrically on the face. 

The marks of Melasma are flat, and they do not itch, burn or hurt. 

You must consult your doctor immediately and seek treatment if you find these symptoms. 


The dermatologist or other healthcare provider will examine your skin to diagnose Melasma. 

The doctor might look at your skin under a wooden lamp to see the level of pigmentation. 

A wood lamp is a type of black light that illuminates the skin properly. 

As a result, it is easy for the doctor to see pigmentation and sun damage compared to normal skin. 

This lamp exposes sun damage on the skin’s surface and the damage which is not visible to the naked eye.

Your doctor might also ask for a thyroid check because there is some link between thyroid disease and Melasma. 

Sometimes, Melasma can be mistaken for another skin condition, due to which a biopsy of the affected area is done. 

Although rare, it is done to confirm whether it is Melasma. 

This skin disorder is not contagious but is a widespread cosmetic problem. 

You need to know that Melasma is not a precancerous skin condition, so it will not become skin cancer. 

But if you are overexposed to the sun, which is a trigger factor for developing Melasma, you can develop skin cancer. 

Treatment for Melasma

Melasma is not harmful, but treating it under the doctor's supervision is always better. 

If you suffer from Melasma during pregnancy, it will gradually fade away. 

Once the medicines are stopped, women taking oral contraceptives or hormone replacement therapy will see patches fading. 

However, some treatment options can help you to deal with Melasma effectively.


It is a cream that takes pigment out from the skin and hunks natural chemical processes that cause the creation of melanin. Melanin is a substance that makes your skin dark. 

Azelaic acid cream 

Azelaic Acid cream works by slowing down or averting pigment production, which makes skin dark. 


Vitamin A increases the rate at which dead skin cells fall off and new ones appear. 

Tretinoin Gel helps disappear the melasma patch quickly as the pigmented cells are shed. 

Intense pulsed light therapy 

This therapy uses specific wavelengths of light to target and eliminates pigmented areas of skin. 

Chemical peels

A liquid solution applied to the skin further peels off the burned layers. 

Therefore, Melasma is a common skin condition that can be treated easily.

Are there complications/side effects of the medications used for Melasma?

While using Hydroquinone and Tretinoin, some people may suspect side effects like Dermatitis. Azelaic cream, lotion, or gel can cause a sting on the area where you apply it. 

Before using any medication, check for an allergic reaction. Use a small amount of topical cream, lotion, or gel and seek its reaction on your skin. You may start using it if it feels safe and does not cause any allergic reaction. 

Each medication may have side effects, so check them before using them. Report your healthcare provider if you suspect any side effects after using it. 

Treatments like chemical peels and lasers may cause the skin's surface layers to die. It may also lead to post-procedure hyperpigmentation and hypertrophic scars. Discuss a specialist with experience treating Melasma and choose the treatment with minimum risk factors. And make sure to use the topical medications precisely as prescribed to prevent the risk of side effects and other complications. 

Some FaQs

How do you stop Melasma from coming back?

Protecting yourself from the sun may help in preventing faded Melasma from returning. It is essential to use sunscreen every day for sun protection. But If you do not prefer sunscreen because it leaves a white cast on your skin, you may use tinted sunscreen. Moreover, you may wear a wide-brimmed hat or cover the area with a thin cotton cloth for sun protection. 

Is melasma permanent?

Melasma is a chronic disorder that may last for 3 months or more. Some people have to deal with them for years or their entire lives. In contrast, others have melamine briefly, especially during pregnancy. 

Can Melasma be prevented?

No, you can't prevent Melasma because you can't avoid genetics or stop the skin condition when pregnant. But you stop them from getting worsen by taking treatment and precautions. You may include a skin-friendly diet in which you can take adequate amounts of Vitamin D that may help with skin conditions. 

Is Melasma cancerous?

No, Melasma is not cancerous. Melasma appears flat on the skin and both sides of your face. It does not include bumps on the skin and appears as brown or blue-gray patches or freckle-like spots. But some skin cancers may mimic Melasma, so talk to your dermatologist if they arise.