Medical Dermatology - Melasma

Melasma is a common skin condition. Causing brown to gray-brown patches, melasma usually appears on the face. The cheeks, bridge of nose, forehead, chin, and upper lip are places where melasma is likely to form. It also can develop on the forearms and neck.

What causes melasma is still unknown. People with a family history of melasma are more likely to develop this skin condition. Pregnancy, birth control pills, cosmetics, hormone therapy, phototoxic drugs (make the skin more susceptible to light damage), antiseizure medication, and sun exposure often trigger melasma.

Because melasma is common and causes characteristic brown patches on the face, dermatologists diagnose most patients by looking at their skin. Occasionally, a skin biopsy is necessary to confirm that the brown patches are melasma.

A variety of creams are available to treat melasma. An active ingredient in these creams may be hydroquinone, a commonly used skin-lightening agent. If you notice irritation or darkening of the skin with a skin-lightening cream, consult your dermatologist immediately.

A dermatologist may prescribe a cream with a higher concentration of hydroquinone. A dermatologist also may prescribe creams containing tretinoin, corticosteroids, or glycolic acid, which may be combined with hydroquinone to enhance the skin-lightening effect. Another active ingredient that is being used to treat other conditions but also can help fade melasma is azelaic acid. Kojic acid may also help fade melasma. A chemical peel, microdermabrasion, or laser surgery also may be used to treat melasma.