Melasma: Symptoms, Causes, Treatment & Prevention for Facial Dark Patches

Melasma is a common acquired hyperpigmentation disorder that causes symmetrical brown, gray-brown, or tan patches on the face. It frequently affects the cheeks, forehead, upper lip, and chin, and is sometimes called the “mask of pregnancy.” While harmless, melasma can be persistent and emotionally distressing, particularly for women. Sun exposure and hormones are major triggers.

• Irregular brown or gray-brown patches on sun-exposed facial areas
• Symmetrical distribution (often centrofacial or malar pattern)
• No itching or pain—purely cosmetic
• Worsens with sun exposure or hormonal changes
• May also appear on forearms or neck

Patches can vary in size and darken over time without intervention.

Melasma results from overactive melanocytes stimulated by:

• Hormonal changes (pregnancy, birth control, HRT)
• UV and visible light exposure
• Genetics and skin of color (more common in women)
• Certain medications or cosmetics

It is not contagious and often appears between ages 20–40.

Treatment combines sun protection with pigment reduction:

• Topical hydroquinone, tretinoin, azelaic acid, or triple cream
• Chemical peels or microdermabrasion
• Laser and light therapies (carefully selected for skin type)
• Oral tranexamic acid for resistant cases

Results take weeks to months; maintenance is essential to prevent recurrence.

• Broad-spectrum SPF 30+ daily, reapply every 2 hours
• Wear wide-brimmed hats and seek shade
• Use gentle, non-irritating skincare
• Avoid hormonal triggers when possible
• Consistent year-round sun protection is key

Consult a specialist for persistent dark patches, especially if over-the-counter products fail or you are planning pregnancy. A dermatologist can tailor safe, effective therapy and rule out other conditions.

• Is melasma curable? It can fade significantly but often requires ongoing management.
• Does pregnancy cause melasma? Yes—“mask of pregnancy” is common and may resolve postpartum.
• Can men get melasma? Yes, though it is far more common in women.
• Best sunscreen for melasma? Mineral-based with iron oxides for visible light protection.
• How long until melasma fades? Improvement often seen in 4–12 weeks with consistent treatment.

Melasma is treatable with dedication to sun protection and medical therapies. Many patients achieve noticeable lightening and renewed confidence. For personalized melasma treatment, request an appointment at Palmetto Skin and Laser Center. Call (803) 329-6030 or book online—expert care for even, radiant skin is available.