Melasma

Melasma is a form of hyperpigmentation, which means an area of the skin becomes darker than the surrounding skin. The patches are usually brown or gray-brown and tend to appear on the cheeks, forehead, nose bridge, upper lip, and chin. Because these areas are prominently visible, melasma can significantly affect how people feel about their skin.

Although melasma is not contagious or dangerous, it can be challenging to manage. The condition often requires a personalized approach, as treatments that work for one person may not be as effective for another.

Melasma can affect anyone, but it is most common in women aged 20 to 40. Hormonal changes play a significant role. Women taking birth control pills or hormone replacement therapy may also notice melasma appearing or worsening.

Men can also develop melasma, though they account for a smaller proportion of cases. People with medium to dark skin tones, especially those of Hispanic, Asian, Middle Eastern, or Mediterranean descent, are more prone to melasma. This is because higher levels of natural pigments make their skin more sensitive to changes in melanin activity.

The main symptom of melasma is the appearance of flat, darkened patches of skin. These patches often have the following characteristics:

• Color ranging from light brown to gray-brown
• Symmetrical distribution, with patches appearing on both sides of the face
• Sharp borders that distinguish them from the surrounding skin

In some cases, melasma can also develop on the neck and forearms, though this is less common. The patches are typically symmetrical, meaning they show up on both sides of the face in a similar pattern.

Melasma most commonly affects the face, but it can also appear on other areas frequently exposed to the sun, such as the forearms or neck. Unlike some other skin conditions, melasma does not cause pain, itching, or scaling. The concern is cosmetic, but its impact on self-esteem can be significant.

The exact cause of melasma is not fully understood, but experts know it results from overproduction of melanin, the pigment that gives skin its color. Several triggers contribute to this overproduction:

• Sun exposure: Ultraviolet (UV) rays stimulate pigment-producing cells in the skin, called melanocytes, to produce more melanin. Even a small amount of sun exposure can worsen existing melasma or cause it to reappear after it has faded. This is why sun protection is essential for anyone managing melasma.
• Hormonal changes: Pregnancy, oral contraceptives, and hormone replacement therapy can all influence melanin production. The hormonal fluctuations during these times often activate or intensify melasma.
• Genetics: A family history of melasma increases the likelihood of developing it. If close relatives have experienced melasma, there is a higher chance that it may appear in future generations.
• Skin irritation: Harsh skincare products, heat, or friction on the skin may sometimes trigger melasma or make it worse by causing inflammation.

Melasma can be unpredictable. For some people, it fades naturally after pregnancy or when they stop hormone therapy. For others, it can persist for years. Because the condition is strongly linked to sun exposure, wearing broad-spectrum sunscreen daily, even on cloudy days, is one of the most effective ways to manage and prevent flare-ups. Wide-brimmed hats and sun-protective clothing also play an essential role.

Managing melasma often requires patience and consistency. Dermatologists may recommend topical creams, chemical peels, or laser treatments, depending on the severity of the condition. Since triggers differ from person to person, professional evaluation is essential for creating the right plan.

If you notice dark, patchy discoloration on your face or body that doesn’t fade with time or sun avoidance, it is a good idea to consult a dermatologist. Professional care helps confirm the diagnosis and rule out other skin conditions that may appear similar. More importantly, a dermatologist can guide you toward safe, effective treatments designed for your skin type and lifestyle.