A Cosmetic Concern

Melasma is a skin condition characterized by symmetrical patches of dark discoloration of the skin. What this means is that these patches will often appear in a similar pattern on both sides of the body. For example, they could appear on both cheeks. Long-lasting uneven skin tone – dark patches on the face, limbs, and other body areas – may be a sign of melasma. Melasma is a form of hyperpigmentation.

Hyperpigmentation simply means an overabundance of pigmentation.

Melasma affects women more often than men. In fact, the Skin of Color Society reports that 90% of people with melasma are women. It usually affects young women more frequently than older women. Pregnant women can experience melasma during pregnancy as a result of hormonal changes. This is sometimes called “the mask of pregnancy.”

How is Melasma Identified or Diagnosed?

Melasma is often identified by its characteristic symmetric distribution and patchy appearance. A dermatologist can identify melasma based on a visual examination. The characteristic appearance of melasma is usually enough to determine a diagnosis, though the doctor will likely ask questions about when and how the condition began. Since melasma may be inherited and runs in families, the doctor may also ask about family members who may have similar skin concerns.

If needed, there are a few tests that can help support the diagnosis of melasma.

Wood's Lamp is a special light that, when shined on the skin, can make it easier for a doctor to see the variation in skin pigmentation.

Biopsy - a tiny sample of skin that the doctor removes - can be tested to confirm melasma.

What Causes Melasma?

As a natural defence mechanism, the skin revs up production of melanin through a complex process that involves numerous different types of cells in the skin. These may include hormones and immune cells, among others. The process begins when the skin receives a signal of potential damage and usually lasts for a brief period. Melasma develops when this natural process is too robust or does not turn off.

Multiple factors can contribute to melasma. For example:

Genetic contributors

Hormonal factors

Sun exposure

High heat exposure and stress

Is Melasma Dangerous?

Melasma is not dangerous. However, individuals may also become frustrated and stress over the appearance of melasma. People with melasma also may report low self-confidence and feelings of depression.