Melasma is a common form of hyperpigmentation that causes dark patches to develop on the face and other areas of the body commonly exposed to sunlight.
Possible causes of melasma include sun exposure, changes in hormones, and skincare products that contain irritating chemicals. The dark patches develop as a result of malfunctioning melanocytes, the cells that produce color in the skin.
Females and people with dark complexions are at a higher risk of developing melasma. Although it is harmless, some people may seek treatment for aesthetic reasons.
Read on to learn more about melasma on dark skin, how doctors diagnose it, how to prevent it, and more.
The symptoms of melasma look different depending on a person’s skin tone. In general, melasma causes patches of dark skin on high points of the face.
Melasma on dark skin appears as dark brown or grey-brown patches. These patches often appear in a symmetric pattern on both sides of the face.
These patches often appear on the:
- upper lip
These patches can also appear on other parts of the body that a person exposes to the sun, such as the:
The patches usually have irregular borders. Some patches form flat solid patches of discoloration, while others have a freckly or blotchy appearance.
Melasma occurs when melanocytes produce too much pigmentation in the skin, resulting in dark patches. People with black or brown skin have more melanocytes. This means that they are more likely to develop melasma than people with lighter complexions.
This condition usually develops in adults in their 20s or 30s. However, some forms of melasma do not appear until a person reaches their 40s.
Melasma occurs more often on female skin than on males. According to the American Academy of Dermatology (ADD), only 10% of people with melasma are male.
Possible causes of melasma include:
- frequent sun exposure
- skincare products that contain irritating ingredients
- hormonal changes that occur during pregnancy or while taking hormonal birth control
Melasma due to hormonal changes will fade once hormone levels return to normal. This can happen after pregnancy ends or once a person stops taking hormonal birth control.
Certain medical conditions can cause hormonal imbalances. Examples include:
Treating an underlying hormonal imbalance may help improve melasma symptoms.
Melasma causes distinctive skin changes that most doctors or dermatologists can identify easily. A doctor may use a Wood’s light to see how far melasma has penetrated the skin.
Melasma can resemble other hyperpigmentation conditions. A doctor may order a skin biopsy to rule out other diagnoses, such as melanoma or dermatitis.
Melasma does not typically require treatment. However, some people may seek treatment for aesthetic reasons. While various topical agents and cosmetic procedures can help fade melasma patches, not all treatments work for everyone.
Treatment might not completely clear melasma patches, and melasma can return even after successful treatment.
Since sun exposure can contribute to melasma, people must wear sunscreen to protect their skin and prevent melasma flares.
Treatment options for melasma include:
Topical creams and gels are the first-line treatment options for melasma. Hydroquinone is an over-the-counter (OTC) topical medication that lightens the skin. Although hydroquinone can help improve the appearance of melasma patches, it can cause side effects.
Side effects of hydroquinone include:
- dry skin
- a burning or tingling sensation
- blue-black discoloration
People can use hydroquinone alone or in combination with other topical therapies.
In a 2015 study, researchers randomly assigned 233 participants a cream containing hydroquinone, fluocinolone acetonide, and tretinoin or a placebo cream. After 8-weeks of daily use, the combination cream was 64.60% effective, and the placebo was 0.88% effective in treating melasma in Chinese people.
Other topical agents that may improve melasma include:
If hydroquinone and other topical therapies do not improve melasma, laser and light-based treatments may help. Laser therapy does not affect melanocyte activity. Instead, it removes pigmentation from the skin.
Unfortunately, laser therapy can cause post-inflammatory hyperpigmentation and lead to rebound melasma flares. It is best to use laser therapy alongside topical treatments.
Medical procedures may help fade melasma patches if topical treatments do not work. These include:
- Chemical peel. A chemical peel uses glycolic acid to promote rapid skin cell turnover. This procedure may help remove discolored skin cells.
- Microdermabrasion. Microdermabrasion is a form of physical exfoliation. During the procedure, a doctor uses an abrasive tool to remove the outer layer of skin.
- Microneedling. During microneedling, a dermatologist pricks the skin with a very fine needle. According to a 2017 pilot study, microneedling helps stimulate collagen production, and it can even improve melasma and other hyperpigmentation disorders.
Can a change in diet help?
While topical treatments are effective, some people may wonder if they can treat melasma through diet and lifestyle changes. Currently, there are no known foods that improve or exacerbate melasma.
But the authors of one 2017 systematic review found evidence that suggests oral medications and dietary supplements are effective treatments for melasma. The specific dietary supplements cited in this review include beta carotene and procyanidin.
Beta carotene is a red-orange pigment found in colorful fruits and vegetables, such as:
- sweet potatoes
Procyanidin is another plant compound commonly found in:
While melasma is treatable, people can take steps to prevent melasma. These steps include:
- wearing sunscreen daily
- wearing broad-brimmed hats outside
- avoiding direct sun exposure
- using gentle skincare products
- eating a healthful, balanced diet
- maintaining a healthy weight
- managing any underlying health conditions
Melasma is a common pigmentation disorder that causes dark patches to form on the skin of the face and upper body. It occurs when specialized skin cells, called melanocytes, produce too much pigment.
People with dark skin have more melanocytes and have a higher chance of developing melasma. Melasma on dark skin causes dark brown or grey-brown patches.
OTC and prescription creams can help lighten melasma patches. Other treatments include laser therapy, microdermabrasion, and microneedling. However, melasma can return even after successful treatment.
People can prevent future melasma flares by wearing sunscreen and avoiding direct sun exposure.