Melasma is a common dermatological condition that causes hyperpigmentation, resulting in brown and dark spots and skin discoloration.

The condition can affect people of all ages, but is more common in adulthood.

The most common causes are sun exposure, and hormonal fluctuations associated with pregnancy, making it more common in women. In some cases melasma may fade on its own, others may require treatment.

Melasma signs and symptoms

Spots and discolorations usually develop on the face, especially on the chin, nose, cheeks and forehead. People with melasma usually notice dark brown or gray patches on their skin. Melasma can also develop on other parts of the body that receive frequent sun exposure, such as the neck, arms and hands.

Because the condition is especially common in pregnant women, it is also called the mask of pregnancy.

Prolonged sun exposure can also increase the risk of developing facial freckles and other forms of skin cancer.

What Causes Melasma?

The two main causes of melasma are hormonal changes (referred to as chloasma when caused by pregnancy) and prolonged sun exposure. Women who take birth control pills or hormone replacement therapy are also at a higher risk of developing melasma.

Hormonal stresses common during menopause can also increase the risk of developing melasma. It is believed that there is an increased female hormones, estrogen and progesterone that overstimulate melanocytes, which are the cells in the epidermis responsible for the production of melanin.

Women with brown/light brown skin who live in climates with higher sun exposure have more risk for facial hyperpigmentation.

Are dark spots on the face dangerous?

A prolonged exposure to the sun's UV rays can cause premature aging and wrinkles and increase the risk of skin cancer. In rare cases, dark spots on the face can also be a symptom of underlying health problems such as thyroid disease or Addison's disease (Suprasarenal Melasma).

Can facial hyperpigmentation be prevented?

When the cause is a hormonal imbalance from birth control pills, hormone therapy, or a side effect of certain medications, dosage adjustments can usually be made. Because Melasma is also caused by sun exposure, protecting the skin from UV rays is the best way to prevent pigmentation and skin cancer.

Dermatologists recommend regularly applying a sunscreen of at least SPF30 with broad-spectrum protection, reapplying every two hours. Protective clothing, sunglasses are also important for protection.  Depending on the concentration of pigment and assessment of the condition, the specialist doctor builds the treatment protocol for you.