Melasma is a common skin problem that causes discoloration of the face. It may result in brown to gray-brown patches on the cheeks, nose, forehead, chin, or upper lips. It is much more common in women, especially during pregnancy, as it is commonly called the mask of pregnancy. The skin color does not cause itching or pain, but may create significant cosmetic concerns. The change in skin color can be caused by sun exposure, changes in hormones, or reactions to skin care products. If melasma is caused by a change in hormones or a sudden reaction to a skin care product, it may resolve quickly on its own. If not, there are many topical treatments including hydroquinone, tretinoin, and cosmeceuticals, as well as procedures which include chemical peels, microdermabrasion, microneedling (Rejuvapen) and laser (alex and aurora)
The most common treatment however, is sun protection and sun avoidance.
Melasma manifests as a variable darkening of the skin, usually favoring the central face. It is more common in darker skinned women, although men and people with lighter skin may also be affected. The cause of melasma in unknown, but seems to be related to hormonal factors as well as sun exposure. Indeed, many women notice its onset during pregnancy or after starting birth control pills. Both of these factors can alter hormonal levels.
All treatments must incorporate strict sun avoidance and sun protection with high SPF sunscreens and wide-brimmed hats.