Melasma

Melasma is a common skin pigmentation disorder in which flat brown or greyish patches develop on sun-exposed skin, usually the face, because pigment-producing cells make too much melanin. It is more frequent in women, especially during pregnancy, and in people with brown skin tones, though anyone can be affected. Contributing factors include pregnancy, hormonal medicines such as contraceptive pills and hormone replacement, ultraviolet exposure, family history, and occasionally thyroid problems or anti-epileptic drugs. The patches are often symmetrical on the cheeks, forehead, nose and upper lip, and the skin is not itchy or painful, though appearance can distress. Doctors usually diagnose it by looking at the skin, sometimes with a Wood's lamp, and a biopsy is occasionally used to exclude other conditions. No cure exists at present, but sun protection, stopping trigger hormones, hydroquinone, retinoid or azelaic acid creams, tranexamic acid, peels, laser and camouflage can improve appearance.

Seek urgent care for a rapidly spreading rash with fever, a rash with blisters or peeling, or facial swelling. See a doctor for skin changes that do not improve with over-the-counter treatment after a few weeks, a mole that changes, or acne that is scarring or affecting your confidence. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.