Often confused with sunspots or hyperpigmentation, melasma is a somewhat mysterious skin condition that isn’t nearly as commonly discussed—mainly because it’s still a bit unclear as to what exactly causes it. We spoke with dermatologist Dr. Gary Goldfaden and asked him our burning questions like: What is it? Who gets it? Can it be treated? He answered all our queries, and then some. Curious about this skin condition? Find out more below.
First things first—what exactly is it? “Melasma is a common skin condition that causes the appearance of brown to gray-brown patches of skin,” Dr. Goldfaden says. “[This is due] to the body producing too much melanin, a natural substance that gives color to our hair, skin, and eyes.”
Melasma is much more common in women than men—only 10% of people who get melasma are men. People with darker skin also have a higher chance of getting melasma, according to the American Academy of Dermatology. Those with darker skin tones might have a harder time getting treated for melasma as well—Goldfaden says that women of color sometimes experience Post Inflammatory Hyper-Pigmentation, an additional level of inflammation below the skin’s surface.
Here’s where things get a bit murky. The exact cause of melasma is unknown, though there are many possible contributing factors. The two main triggers are thought to be hormones and sun exposure—this is why many women might notice melasma developing during their pregnancy or after starting birth control. “Hormones trigger melasma, and sun exposure makes it worse,” Goldfaden says.
Melasma most commonly appears on the face, but it can also develop on your forearms and neck. Don’t assume every dark spot on your face is melasma, however—they could just be sunspots or hyperpigmentation. How can you tell? Goldfaden says melasma appears in a more uniform manner, and is more commonly found in patches—not spots—across your cheeks. Other than the appearance on your skin, there are no other symptoms—in other words, it won’t make your body feel any different.
If you think you have melasma, pay a visit to your dermatologist—most of them can diagnose it just by taking a look at your skin. In terms of treatment, Goldfaden recommends avoiding the sun first and foremost: “The more sun exposure, the more the melanin will get stimulated.” If the melasma is caused by hormonal changes, you may just have to wait it out—it can fade on its own.
If, however, it isn’t going away on its own, your dermatologist may prescribe a topical treatment with hydroquinone, tretinoin, or corticosteroids. Chemical peels, microdermabrasions, and dermabrasions have also been used to treat melasma.
If it was caused by hormones, then yes, melasma can fade after your pregnancy or after you get off birth control. However, it can be stubborn and take months—even years—to see any type of improvement. In the end, all you can do is follow your dermatologist’s advice and always wear an SPF. Goldfaden says to exfoliate often—whether physical or chemical—and use a lightening serum in the meantime to help fight discoloration.