Home > Diseases and Conditions > Melasma
Printer friendly viewPrint
Bookmark and Share

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Melasma

Chloasma; Mask of pregnancy; Pregnancy mask

Last reviewed: October 3, 2010.

Melasma is a dark skin discoloration that appears on sun-exposed areas of the face.

Causes, incidence, and risk factors

Melasma is a very common skin disorder. Though it can affect anyone, young women with brownish skin tones are at greatest risk.

Melasma is often associated with the female hormones estrogen and progesterone. It is especially common in pregnant women, women who are taking birth control pills (oral contraceptives) and women taking hormone replacement therapy (HRT) during menopause.

Sun exposure is also a strong risk factor for melasma. The condition is particularly common in tropical climates.

Symptoms

Melasma doesn't cause any other symptoms besides skin discoloration but may be of great cosmetic concern.

A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip. It is most often symmetrical (matching on both sides of the face).

Signs and tests

Your health care provider can usually diagnose melasma based upon the appearance of your skin. A closer examination using a Wood's lamp may help guide your treatment.

Treatment

Treatments may include:

  • Creams containing a combination of tretinoin, kojic acid, and azelaic acid have been shown to improve the appearance of melasma.

  • Your doctor may recommend chemical peels or topical steroid creams.

  • In severe cases, laser treatments can be used to remove the dark pigment.

Avoiding the sun and using sunscreen are key to preventing melasma.

Expectations (prognosis)

Melasma often fades over several months after stopping birth control pills or HRT, or after delivering a child. It may return with additional pregnancies or use of these medications.

Calling your health care provider

Call your health care provider if you have persistent darkening of your face.

Prevention

Daily sunscreen use not only helps prevent melasma but is crucial in the prevention of skin cancer and wrinkles.

References

  1. Habif TP. Light-related diseases and disorders of pigmentation. In: Habif TP, ed. Clinical Dermatology. 5th ed. St. Louis, Mo: Mosby Elsevier; 2009:chap 19.
  2. Sood A, Tomecki KJ. Pigmentary disorders. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010.

Review Date: 10/3/2010.

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2012, A.D.A.M., Inc.

What works?

  • Treatments for melasma (darker than normal skin occurring in patches) Treatments for melasma (darker than normal skin occurring in patches)
    Melasma is a psychologically distressing skin disorder also known as ‘chloasma’ or ‘mask of pregnancy’. Darker patches of skin gradually develop on the cheeks, forehead, nose, and upper lip. It is more common in women and is associated with pregnancy and medication containing hormones. Melasma is divided into three types: epidermal, dermal, and mixed melasma. Epidermal melasma is the most superficial with an increase in the skin pigment (melanin) in the top layer of skin (epidermis). In dermal melasma, there is increased skin pigment in the second deeper layer of the skin (the dermis). Mixed melasma is a combination of epidermal and dermal melasma.
See all (1)...

Drugs of interest

  • Tretinoin
    Tretinoin is used to treat acute promyelocytic leukemia (APL; a type of cancer in which there are too many immature blood cells in the blood and bone marrow) in people who have not been helped by other types of chemotherapy or whose condition has improved but then worsened following treatment with other types of chemotherapy. Tretinoin is used to produce remission (a decrease or disappearance of signs and symptoms of cancer) of APL, but other medications must be used after treatment with tretinoin to prevent the cancer from returning. Tretinoin is in a class of medications called retinoids. It works by slowing or stopping the growth of cancer cells by causing immature blood cells to develop into normal blood cells.
  • Azelaic Acid Topical
    Azelaic acid gel is used to clear the bumps, lesions, and swelling caused by rosacea (a skin disease that causes redness, flushing, and pimples on the face). Azelaic acid cream is used to treat acne. Azelaic acid is in a class of medications called dicarboxylic acids. It works to treat acne by killing the bacteria that infect pores and by decreasing production of keratin, a natural substance that can lead to the development of acne. The way azelaic acid works to treat rosacea is not known.

MedlinePlus.gov links to free, reliable, up-to-date health information from the National Institutes of Health (NIH) and other trusted health organizations.

Learn about...

  • Tips for reading the news Tips for reading the news
    Don’t automatically believe the headlines. Learn how to figure out which articles you’re going to believe and which you’re not.

Recent activity

Clear Turn Off Turn On

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...