Facial Hyperpigmentation

Facial Hyperpigmentation

What is melasma? — Melasma is a condition that causes brown patches on the skin. The patches are usually on the face.
Melasma is common in women who are pregnant, but women who are not pregnant can also get it. Men can get it, too. Melasma is most common in people with darker skin and people who live in very sunny places.
What are the symptoms of melasma? — Brown patches on the skin are the main symptom of melasma. The patches can be light or dark brown or sometimes gray or blue.
It is most common for melasma to happen on the cheeks, forehead, upper lip, nose, and chin. Melasma can also happen on the jaw.
Should I see a doctor or nurse? — If you notice brown, gray, or blue patches on your skin, talk to your doctor or nurse. Some other conditions can also cause darker areas on the skin.
Is there a test for melasma? — No. There is no test. The doctor or nurse should be able to tell if you have it by learning about your symptoms and doing an exam.
How is melasma treated? — The doctor or nurse can prescribe a cream to lighten the dark patches. If the melasma is not gone after 2 or 3 months, the doctor or nurse can prescribe a different cream.
If you have melasma, you should also:
Always wear sunscreen that protects against UVB and UVA rays (sample brand names: Neutrogena sunscreens with Helioplex, La Roche-Posay Anthelios SX). The sunscreen should have a sun protection factor (SPF) of at least 30. Put on more sunscreen every 2 hours while you are outdoors.
Wear a wide-brimmed hat to protect your face from the sun.
If the creams do not make the melasma go away, the doctor might recommend a treatment called a "chemical peel." In this treatment, a product such as glycolic acid is put on the skin. It makes the top layer of skin peel off. This can take off the melasma patches.
Melasma caused by pregnancy usually goes away in about a year. But melasma can be a long lasting condition. The dark patches do not always go away completely, even with treatment. They can also come back if you stop using sunscreen and other sun protection.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83982 Version 4.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.