Melasma

    Melasma is an acquired pigmentation disorder that usually causes symmetrical brown or grey-brown patches on the face. It is more common in women and in medium to darker skin tones. Other pigment disorders can resemble it, so diagnosis should be confirmed before treatment.

    Last reviewed: November 20263 sources

    What you may notice

    • Blotchy patches on both sides of the face
    • Colour on the cheeks, forehead, upper lip or jaw
    • Darkening after sun or heat exposure
    • Changes during pregnancy or hormonal treatment
    • Seasonal fading and recurrence

    Why it can happen

    Ultraviolet and visible light stimulate pigment production. Hormonal influences, pregnancy, genetic susceptibility and some medicines or cosmetics may contribute. Melasma is often chronic and relapsing. It is not dangerous, but procedures or irritation can worsen it through post-inflammatory hyperpigmentation.

    What may help

    Consistent broad-spectrum and visible-light protection is central. Dermatologists may use topical pigment-regulating medicines or carefully selected combinations. Chemical peels and energy-based treatments are sometimes considered, but evidence and risk vary, particularly in darker skin tones. Maintenance is often needed because recurrence is common. Pregnancy and medical history affect which options are appropriate.

    When to consult

    Consult a dermatologist if the diagnosis is uncertain, pigmentation is changing or a treatment has worsened it. Professional advice is particularly important during pregnancy, with darker skin tones, or before peels and laser treatment.

    Related options

    2 options

    Treatments

    Evidence and sources

    1. DermNet. Melasma [Internet]. Auckland: DermNet New Zealand Trust; 2025 [cited 2026 Nov 7]. Available from: https://dermnetnz.org/topics/melasma
    2. American Academy of Dermatology. Melasma: overview [Internet]. Rosemont (IL): American Academy of Dermatology; [cited 2026 Nov 7]. Available from: https://www.aad.org/public/diseases/a-z/melasma-overview
    3. American Academy of Dermatology. Melasma: diagnosis and treatment [Internet]. Rosemont (IL): American Academy of Dermatology; [cited 2026 Nov 7]. Available from: https://www.aad.org/public/diseases/a-z/melasma-treatment