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Melasma is a common cause of increased pigmentation.  Individuals with melasma develop brown patches , typically with an irregular outline and sharp border.  These most commonly occur on the face, but can be seen in other areas such as the neck, chest or arms.  

Who gets Melasma?

Melasma is much more common in women; only 10% of people who get melasma are men.  It is most common in young or middle-aged women and is more common in those with skin of colour.

What Causes Melasma?

The exact cause of melasma is unknown.  It's thought that hormones and sun exposure play important roles.  Melasma is often brought out by pregnancy, the use of birth control pills, and sun exposure.  Spots sometimes fade in the winter and recur in the summer.

How is Melasma Treated?

  1. Sun protection is of the utmost importance.  People with melasma need to use a broad-spectrum sunscreen all year, and especially when out in the sun.  Sunscreens need to be applied liberally and re-applied every 2 hours when outdoors.  
  2. In addition to sunscreen, hats and sun-protective clothing and hats can be helpful
  3. Topical bleaching creams are the mainstay of treatment of melasma.  Often these contain several ingredients that work together to lighten the skin
  4. Chemical peels can be helpful in some patients with melasma
  5. Laser treatments are sometimes used if topical medications have not been helpful
  6. Recurrences of melasma after treatment are common.  Strict sun protection/sun avoidance may minimize recurrences