Melasma is a chronic condition requiring long term management that includes a combination of strict sun protection and avoidance of sun, heat and skin irritation. Hormones and genetics play a role in the development of melasma. Sometimes also called the “mask” of pregnancy, this type of melasma often resolves after pregnancy but can resolve more quickly with treatment. There are two main causes of melasma: radiation, whether ultraviolet, visible light, or infrared (heat) light; and hormones. Ultraviolet and infrared radiation from the sun are key in making melasma worse. Recently, a vascular and mast cell (cells that release histamine) component has come to life.

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Prescription treatments clinically proven to reduce hyperpigmentation, brown patches, and melasma for a more even skin tone - guided by board-certified dermatologists.

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Melasma 101

What Causes Melasma?

Melasma is a common hyperpigmentation disorder that causes symmetrical brown or gray-brown patches, most often on the face. It is physically harmless, but can be persistent and emotionally frustrating. Melasma tends to recur without consistent maintenance because it is strongly influenced by light exposure, heat, hormones, and skin irritation.

Melasma is sometimes called the “mask of pregnancy” because it commonly appears during pregnancy and may fade afterward—though many patients improve more quickly with appropriate treatment.

How to Treat Melasma

Integrative approach to melasma

Effective strategies for melasma treatment include prescription topicals and oral medication along with oral supplements. Combinations of hydroquinone, tretinoin, azelaic acid and steroid cream in varying concentrations and percentages are standard melasma treatments, resulting in significant improvement. Non-prescription lightening agents, like vitamin A and C, kojic acid, and niacinamide, show benefits for melasma skin discoloration and can be used without a prescription. Sun protection with SPF 50 or higher and use of tinted sunscreens are essential for prevention and maintenance.

Cyclical use of prescriptions, natural remedies and chemical peels can prevent and maintain results. At home peels with alpha hydroxy acids, lactic and salicylic acids are very helpful.

Oral tranexamic acid is very effective for melasma and is best used for resistant melasma, although not all patients are candidates for this treatment. Oral supplementation with licorice extract, beta-carotene, astaxanthin, and polypodium leucotomos, can reduce damaging effects of the sun and optimize results.

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