Melasma: What Is It and What Are the 5 Ways to Treat It?

For anyone who has ever been pregnant, right along with those lovely stretch marks, there might also be a sudden appearance of some strange blotches of pigmentation—brown, blue-gray, or tan—on the forehead, nose bridge, and temples. This so-called “mask of pregnancy” can result from taking hormonal birth control, sun exposure, or just having darker skin. However it manifests itself, it’s called melasma.

Whatever its cause, melasma kicks in when the body’s color-making cells—melanocytes—go crazy and start producing too much color and cause the discoloration. There is no cure for melasma, but there are several effective treatments to lessen its effects. These range from over-the-counter products to help at It is not often necessary to treat melasma right away. In many cases, it will disappear or lighten when a woman delivers her child, discontinues birth control, or minimizes sun exposure. If the condition continues, there are several treatment options.


Doctors will often use hydroquinone as a first-line treatment for melasma. Hydroquinone is a skin-lightening agent that is used for a variety of hyperpigmentation problems. It is available as a gel, lotion, or cream.

Hydroquinone is applied directly to the affected patches of skin. It is available in over-the-counter products but can also be prescribed by a physician in the form of stronger creams.

Corticosteroids and Tretinoin

Corticosteroids and tretinoin are combinations of medications used to treat moderate to severe melasma cases, mainly when they occur on the face. These medications are lightening agents available as a cream, lotion, or gel, but only on a prescription basis.

In some instances, a physician may prescribe a combination of these creams that may contain hydroquinone, tretinoin, and corticosteroids all in one product. These are often called triple creams.

Further Topical Medications

Instead of or in addition to any of the medications mentioned above, a physician can also prescribe kojic acid or azelaic acid, both of which are bleaching agents. These are often used in four-month cycles along with Hydroquinone.

In a study conducted by the International Journal of Dermatology, in a 24-week treatment period, a 20 percent azelaic acid yielded good or excellent results in 65 percent of cases. In the latter results, lesions were found to reduce in size and pigment intensity.

Medical Procedures

If medications are not sufficient, a physician might recommend one of the following or a combination of these medical procedures.

  • Laser treatment
  • Microdermabrasion
  • Chemical Peel
  • Dermabrasion
  • Light Therapy

Just as is the case with many medical treatments, some of those above do have some side effects, such as other dermatology problems. Regardless of the medicine being considered, it is best to consult a physician to discuss all of the options and possible side effects.

Anyone who has had melasma would do well to avoid these proven triggers of the condition:

  • Over-exposure to the sun
  • Not using a sunscreen with a sun protection factor of 15 or greater
  • Failing to wear a hat with a broad brim when out-of-doors


Melasma is not fatal. At worst, it is just bothersome and unsightly. Unfortunately, almost all melasma patients are women. Only about five percent of cases are men.

Generally speaking, the treatments for melasma are highly effective and very safe. It is also important to note that, in many cases, when hormonal changes caused by pregnancy cease, melasma-affected areas will go back to normal.

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