Melasma is a skin condition that leads to brown patches on the skin. These patches usually appear on the cheeks, nose, forehead, chin, and upper lip. Patches can also appear on the neck and forearms.

Melasma is common in pregnant women. It is not a harmful condition.

Common Sites on the Face for Melasma

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The level of melanin increases in the body. Melanin causes the brown patches. It is not clear why this increase happens. Factors that may play a role include:

  • Hormones such as estrogen and progesterone
  • Sun exposure
  • Genetics
  • Cosmetics

Risk Factors

Melasma is more common in women during their reproductive years. It can occur in men. Other factors that increase may your chance of melasma include:

  • Pregnancy
  • Taking birth control pills
  • Family history of melasma
  • Having a darker skin tone
  • Getting too much sun exposure
  • Using products that irritate the skin, such as cosmetics
  • Certain medicines, such as antiseizure drugs or hormone therapy


Dark patches of skin.


You will be asked about your symptoms and past health. Your skin will be examined. The doctor can often make the diagnosis based on the appearance of the skin.


Melasma may go away on its own. If it does not go away, it may need to be treated. Talk with your doctor about the best treatment plan for you.

Addressing Cause

  • Melasma during pregnancy may slowly fade after giving birth. It may appear again or darken with later pregnancies.
  • Stopping birth control pills or hormone replacement therapy may help melasma fade. Talk to your doctor about medicine or treatment options.
  • Avoid using products that irritate your skin. Some makeup, creams, and cleansers can lead to melasma.
  • Protect your skin from ultraviolet (UV) light. Avoid sun exposure and tanning beds. Wear sunscreen, clothing, and hats when outdoors.


Creams with medicine may help to lighten skin color. The creams may contain one or more of the following:

  • Hydroquinone
  • Tretinoin
  • Corticosteroids
  • Azelaic acid
  • Glycolic acid

It may take several months to see an improvement.

Other Treatments

The brown patches may also be lightened with:

  • Chemical peel
  • Microdermabrasion—removing top layer of skin
  • Laser therapy


To help reduce your chance of getting melasma:

  • Limit the amount of time you spend in the sun. Avoid using tanning booths.
  • Use sunscreen every day. Wear sunscreen that protects against both UVA and UVB rays. It should also have a sun protection factor (SPF) of 30 or more.

American Academy of Dermatology

Family Doctor—American Academy of Family Physicians


Canadian Dermatology Association

Public Health Agency of Canada


Melasma. American Academy of Dermatology website. Available at: Accessed March 25, 2020.

Melasma. American Academy of Family Physicians Family Doctor website. Available at: Updated August 2018. Accessed March 25, 2020.

Melasma. American Osteopathic College of Dermatology website. Available at: Accessed March 25, 2020.

Tierney EP, Hanke CW. Review of the literature: Treatment of dyspigmentation with fractionated resurfacing. Dermatol Surg. 2010 Oct;36(10):1499-508.

Treatments of common complaints in pregnant women. EBSCO DynaMed website. Available at: Updated March 19, 2020. Accessed March 25, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Mary-Beth Seymour, RN  Last Updated: 11/25/2020