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Melasma is a common skin pigmentation issue that causes dark, blotchy, and uneven skin tone on sun-exposed areas, chiefly on the face. It is more common in women than in men and generally appears for the first time in the 20s to 50s, or during pregnancy.

Although it’s medically harmless, for many people the discoloration is a cause of embarrassment so it is common to seek treatment. Melasma is also called chloasma, or mask of pregnancy.



Melasma causes hyperpigmentation or discolored marks that are darker than your surrounding skin. The skin looks blotchy and uneven, with irregular borders on the discolored spots. Excisional biopsy: a surgical blade is used to completely remove the growth. The resulting wound is usually stitched side by side. As with the punch biopsy, the resulting scar is linear. If non dissolvable stitches are used, they will be removed within 1 to 2 weeks after the biopsy, depending on the location of the treated area.

The discoloration can range from slightly darker than your normal skin color to extremely dark. Depending on your skin tone and the severity of your melasma, the discoloration can be light brown to nearly black.

Melasma develops on sun-exposed areas of the skin, most often the face. Above the upper lip, across the cheeks, nose, and forehead are all very common areas to find it, but melasma can develop anywhere on the face. It also can develop on the chest, upper arms, and upper back, though not as frequently.

The key factor with melasma is that it typically appears symmetrically on the face. You’ll notice “matching” patches on both cheeks, or spots that have developed evenly across the nose or the forehead.



Melasma develops when there is an over-abundance of melanin in certain areas of the skin. Melanin is the substance that gives your skin, eyes, and hair their color. People with dark complexions have skin that produces more melanin; those with lighter complexions have less melanin.

Melanocytes are cells in your skin that create melanin. For reasons that aren’t perfectly clear, these cells sometimes malfunction and start making more melanin in certain areas than in others. The excess melanin produces the dark, blotchy areas we know as melasma.

With melasma, the discoloration is mostly of the epidermis, which is the uppermost layer of the skin. There is growing evidence, though, that while the hyperpigmentation is localized to the epidermis, the deeper layers of the skin (the dermis) also has a role in melasma development.


Who is at risk of melasma?

Fairer-skinned people are less likely to be affected by melasma than those with darker brown skin or those who tan well. Women are more likely to get melasma than men: about 10% of those who get melasma are men, 90% women. Pregnant women get melasma more often than anyone else. You’re also at risk if you take oral contraceptives and hormones.


Melasma is hard to treat. To determine a treatment plan, your healthcare provider will have to first figure out what’s possibly causing the melasma. Is it sunlight? Your birth control? Genetics? Your soap? Too much screen time?

Depending on the person, melasma may go away on its own, it may be permanent, or it may respond to treatment within a few months. Most cases of melasma will fade away with time and especially with good protection from sunlight and other sources of light.

Unfortunately, there is no definitive treatment that will automatically make melasma disappear. At this time there is no way to remove dermal pigment.

If you have melasma, be sure to avoid:

  • Hormone treatments, specifically ones that involve estrogen.
  • Birth control, specifically oral contraceptive pills that contain estrogen and progesterone.
  • LED light from your television, laptop, cell phone and tablet.
  • The makeup you find irritating to your skin.
  • Medications that may cause or worsen melasma.
  • Scented soaps.
  • Skin care products that irritate your skin.
  • Tanning beds.
  • Waxing can aggravate melasma.
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