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Melasma: Symptoms, Causes & Treatment

Melasma: Symptoms, Causes & Treatment


What is Melasma?

Melasma is a common ailment that affects the skin. Many people mistake this condition with hyperpigmentation, but they are vastly different. This skin condition causes areas of the face to become discolored. In most patients with melasma, these brown and grey patches will appear on the cheeks, chin, nose, upper lip and forehead. In some cases, these patches may also manifest on the neck or forearms. Any place exposed to the sun on a regular basis increases its risk of developing these spots. Skin discoloration from melasma affects both genders; yet it is more common in women. On average, only 10 percent of those suffering from melasma are men. Aside from exposure to the sun, the condition can also be triggered by hormones. It is a predictable side effect of pregnancy and is often called “mask of pregnancy” by dermatologist and OB-GYNs (x).

Melasma Symptoms

There are no somatic symptoms of melasma. Some signs such as splotchy skin may indicate your dermis is affected by melasma. These are typically the brown and grey patches that appear on areas exposed to the sun. The most traditional areas affected include the following (x): 

  • Forehead
  • Upper lip
  • Cheeks
  • Chin
  • Over the nose

Skin discoloration caused by melasma can also appear on the arms and neck, but this is not as common as other areas.

Melasma Symptoms

Melasma Causes

There is no specific cause for melasma. Most research links the condition as a result of melanocytes creating too much melanin. People with tan and darker skin tones are more likely to develop melisma due solely to the concentration of active melanocytes. Melasma can be triggered by several diverse factors such as (x):

Sun Exposure

The UV light emitted by the sun stimulates the production of melanocytes in the skin. It only takes a limited amount of sun exposure to cause a noticeable flare up. Most cases of melasma tend to worsen in the summer and reduce in the winter months. Because it only takes a minuscule amount of exposure to trigger a flare-up, a person may suffer from chronic bouts of melasma (x).

Hormonal Changes

Hormones occupy a leading role in how your body reacts to various triggers, medications and conditions. Pregnancy is an instance where the body is flooded with copious amounts of hormones used to support a growing baby. These hormones can also cause melasma in expectant women. Chloasma, also called a pregnancy mask, is reasonably common during pregnancy and usually resolves following birth (x, x).

Patients who are on various hormone replacement therapies or birth control may also develop melasma as a result of the increased concentration of key hormones that trigger the condition.


If you have family members or close relatives who suffer from melasma, there’s a greater chance for you to develop it as well. Those whose families tend to be sensitive to progesterone or estrogen are also more prone to developing the condition. Melasma tends to be found more often among the following ethnicities (x):

  • Indian
  • Latin/Hispanic
  • African-American
  • Asian
  • Mediterranean
  • Middle Eastern
  • North African

Skin Care Treatments

Caring for your skin is an extraordinary way to keep it healthy, but sometimes the products can actually trigger melasma. Products that irritate your skin often cause melasma to develop or recur in patients with chronic melasma (x).

How is Melasma Diagnosed?

It’s relatively simple to diagnose melasma. A dermatologist will complete a visual examination of the affected areas. In some cases, the dermatologist may request additional tests such as a biopsy in order to rule out other skin conditions. The most widely used test for melasma is the Wood’s lamp exam (x), an assessment using a special light to identify any fungal or bacterial infections that may be lurking on your dermis. A dermatologist can also ascertain how deep your melasma has penetrated (x).

Melasma Remedies and Supplements

If you’re seeking reliable ways to get rid of melasma, your treatment options will vary depending on what triggered the condition. Women suffering from the mask of pregnancy frequently see their conditions fade naturally once hormone levels adjust after birth.

Those who have triggered their condition due to hormone treatments will also typically notice a reduction of their melasma once treatment is stopped. If you’re uncomfortable with how melasma makes you look, your healthcare provider can refer you to support groups in your area. While there are treatments available for the condition, it’s important to keep in mind that they may not work the same for everyone. Some patients may see a recurrence following successful treatment.

Medical Treatments for Melasma

Gentle, non-invasive treatments are always preferred when addressing skin conditions; however, they’re not always successful. In the event that other methods fail, your dermatologist may suggest the following procedures (x, x, x):

  • Dermabrasion
  • Chemical peel
  • Microdermabrasion
  • Laser treatment
  • Dermal resurfacing
  • Light therapy

These types of treatments embody their own unique risks. In some cases, they can cause new skin problems aside from melasma.

Supplements for Melasma

Some of the best melasma treatments available are natural. Nothing is better for your skin than nature itself. Some of the most effective supplements and natural treatments for the condition include these examples:


Turmeric is an Asian herb that’s been used as a form of natural medicine for centuries. It’s an effective way to heal a range of skin conditions, including melasma. The curcumin in turmeric is a potent antioxidant that helps your body to boost cell regeneration. To create a topical application for melasma, five spoons of turmeric and 10 spoons of milk should be mixed into a viscous paste. Apply over the discolored areas and allow it to dry. Wash with lukewarm water. Habitual use may help to even skin tone and boost cell regeneration. The oral recommended dosage is 1,000 mg as a single dose once daily. This supplement should be taken with a meal and a glass of water (x).

Onion Juice

Onion juice may seem like an unlikely remedy for skin conditions, but it has proven effective in restoring an even skin tone. The juice from an onion contains a high concentration of sulfur compounds. These compounds such as cepaenes and sulfoxides effectively target dark pigments in the skin. In addition to promoting an even skin tone, they help revive skin cells, which will give you a brighter complexion (x).

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A dermatologist customarily uses hydroquinone as an initial treatment for melasma. It’s applied topically directly to the afflicted areas on the skin. It serves to help lighten dark spots and even skin tone. Hydroquinone gels and creams are available without a prescription, but stronger concentrations may be prescribed by a medical professional. As with any skin lightening product, it’s critical to use a sunscreen with a high SPF to protect from harmful UV rays (x).

Aloe Vera

Aloesin is a compound found in aloe vera that’s been proven to lighten areas of hyperpigmentation and melasma on the skin. Aloesin helps to lighten the skin by reducing the amount of melanin the body produces. Taken orally, aloe vera can reduce or prevent the mask of pregnancy. The recommended daily dosage is 1,000 mg consumed once daily with a full glass of liquid. As a topical agent, it has the ability to lighten, firm and moisturize the skin. You may use the gel obtained directly from a live plant, or aloe vera powder can be reconstituted into a thin paste (x, x).

Corticosteroids and Tretinoin Combined Creams

In severe cases, a single topical treatment may not produce noticeable results. In these instances, a dermatologist may consider a combination of topical cream as a viable treatment option. Combination creams traditionally consist of corticosteroids, tretinoin and hydroquinone on one treatment. They may also suggest treating the affected area with kojic acid or azelaic acids. These creams have often helped to lighten skin, but they tend to accompany their own list of potential dangers (x).


Hormone imbalances are one of the main causes of hyperpigmentation and melasma. Supplementing with zinc can help break the cycle of imbalance and may reduce the signs of skin discoloration. Zinc is not only essential for healthy skin, but it also plays a vital role in androgen metabolism and testosterone metabolism. Zinc supplements help to filter out excessive amounts of these hormones and increase the efficiency of your thyroid. The recommended dose is no more than 90 mg per day. Zinc should always be taken with a meal to prevent stomach upset (x).

Apple Cider Vinegar

Apple cider vinegar is one of the most versatile natural supplements on the market. It offers a diverse selection of benefits that may range from weight loss to smoking cessation. As a treatment for skin conditions, it can fight acne and possibly lighten dark patches. The acetic acid that occurs naturally in ACV works as a bleaching agent to lighten dark areas and help the skin form a healthier glow. ACV also has natural exfoliating properties which can encourage skin cell regeneration. For topical use in the treatment of melasma, ACV and clean water should be mixed in equal parts. With a clean cotton pad, apply on the affected areas twice daily (x).

The Bottom Line

Melasma is a condition that affects millions of people worldwide. It’s painless and presents dermatological, socio-emotional and psychological challenges. The main effect of melasma is self-esteem, since many patients become unhappy with the way their skin looks. Patients who enlist care from a competent dermatologist tend to achieve positive outcomes. Several medical and natural treatments may be effective in reducing the appearance of the patchy or dark spots. Melasma has a variety of triggers, and the main one tends to be sun exposure. The condition can also be harder to treat in some patients. Regular treatments over the course of several weeks can result in an even skin tone or even a total elimination of melasma.

Medical treatments such as chemical peels and microdermabrasion are sometimes effective in reducing the appearance of dark spots and discoloration. Natural topical treatments such as ACV, turmeric and vitamin C are also effective ways to possibly manage the visual effects of melasma. Following a regular regimen of skincare treatments prescribed by your dermatologist will also likely offer noticeable results. You can also follow a natural routine to produce visible improvement. Natural supplements such as zinc and vitamin C may help dispose of copper from the body while increasing the permeability of skin cells. When your cells are more receptive to topical treatments, it’s easier to remove dark spots, patchy areas and other forms of skin discoloration. To get the most benefit, it’s important not to skip any portion of your treatment.

Although treatment can help to clear your melasma, most people typically require some form of maintenance therapy to keep it from recurring. Wearing sunscreen, avoiding direct sunlight and donning a hat when you go outside are beneficial measures.

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