What Causes Melasma and How It's Treated

Melasma is a common skin condition that causes patches of discoloration, most often on the face. These patches are usually brown, tan, or gray and commonly appear on the cheeks, forehead, bridge of the nose, upper lip, and chin. Although melasma is not harmful or contagious, many people seek treatment because of its effect on their appearance. A dermatologist can diagnose melasma and recommend treatments that help improve skin tone while reducing the likelihood of recurrence.

Melasma develops when pigment-producing cells in the skin create excess melanin. While the exact cause is not always clear, several factors are known to contribute to the condition.

Sun exposure is one of the most common triggers because ultraviolet (UV) rays stimulate melanin production. Hormonal changes during pregnancy or while taking certain hormonal medications can also increase the risk of developing melasma. Genetics may play a role as well, as the condition often runs in families. Heat and visible light exposure may also worsen existing pigmentation in some individuals.

Melasma typically appears as flat, symmetrical patches of darker skin without itching, pain, or raised areas. The discoloration develops gradually and most often affects areas of the face that receive regular sun exposure.

Because other skin conditions can resemble melasma, a dermatologist can perform an evaluation to confirm the diagnosis and rule out other causes of skin discoloration.

Treatment focuses on reducing excess pigmentation while preventing new discoloration from developing. Daily use of a broad-spectrum sunscreen with SPF 30 or higher is one of the most important steps in managing melasma, even on cloudy days.

Depending on the severity of the condition, a dermatologist may recommend prescription topical medications containing ingredients such as hydroquinone, tretinoin, azelaic acid, or other pigment-reducing agents. Some patients may also benefit from chemical peels, laser therapy, or light-based treatments when appropriate. Treatment plans are individualized based on skin type, the depth of pigmentation, and the patient's goals.

Because melasma can return, ongoing maintenance therapy and consistent sun protection are often recommended after initial improvement.

Although melasma cannot always be prevented, reducing sun exposure can significantly lower the risk of flare-ups. Wearing wide-brimmed hats, seeking shade during peak sunlight hours, and applying sunscreen every day are simple but effective preventive measures.

Patients taking hormone-related medications should discuss any concerns with their healthcare provider before making changes to their treatment.

If you notice persistent patches of facial discoloration or changes in your skin that do not improve, schedule an evaluation with a dermatologist. Early diagnosis and personalized treatment can help improve the appearance of melasma while supporting long-term skin health.