Does Botox Affect Melasma?

Can Botox affect or worsen pigmentation issues like melasma?

Doctor Answers 16

Does Botox Affect Melasma

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Botox is injected into facial muscles and would not cause any hyperpigmentation.  Botox only affects the movement of facial muscles. Melasma or brown spots are not caused by Botox.  Injecting Botox will not make your hyperpigmentation worsen.  I would make sure to wear a hat and sunscreen.  Topical creams, chemical peels, IPL, and lasers are all a good options to lighten the pigmentation of the skin.  

Regards Anil Shah


Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Melasma not an issue with Botox

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Melasma is a common,  frustrating, chronic condition that is usually accompanied by much emotion. Thankfully, Botox/Dysport treatments will not exacerbate the condition. 

If you are struggling with melasma, you may want to view our many blogs on our website that serve as an educational source.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox and Melasma

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Thanks for your question -

Botox will not change melasma.  Botox directly interferes with the neuromuscluar junction.  Melasma is characterized by hyperpigmentation.  The pharmocologic action of Botox is completely unrelated to hyperpigmentation.

I hope this helps.

Botox is used to treat dynamic wrinkles of the face

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Melasma is a skin condition characterized by excessive pigmentation. There are several causes of melasma, including hormones, sun exposure, genetics, and inflammation.

Botox is used to treat dynamic wrinkles of the face. The product works by inhibiting the release of a neurotransmitter across the synaptic membrane of the nerve. Botox has no effect on melanocyte function and thus cannot influence melasma.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Botox does not affect Melasma

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Botox is a cosmetic injection to relax wrinkle- causing facial muscles and temporarily smooth moderate to severe frown lines. There is no evidence or patients reports that botox could affect or worsen Melasma. Before the treatment talk to your plastic surgeon about any of your concerns.

Botox does not make melasma worse

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Melasma is a benign skin condition characterized by excessive pigment deposition in the skin. Hyperpigmentation is generally diffuse in the area of the upper cheeks, forehead, and jawline. The top 4 causes of melasma are hormones (estrogen, progesterone), genetics, sun exposure and inflammation of the skin.

Botox does not affect melasma at all. There is no relationship. I even conducted a quick medline search with the key words of 'melasma' and 'Botox' and nothing came up, confirming the clinical basis for my answer.

Botox does not exacerbate melasma

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Botox has not exacerbated melasma. If a numbing cream is applied prior to the administration of Botox and should an irritation occur from this application, then melasma could be worsened. Any physical irritation or rubbing or sunexposure can worsen the melasma.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

There should be no relationship between Botox and melasma

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Melasma, or the 'mask of pregnancy', is discoloration or hyperpigmentation patches usually around the cheeks, nose, and upper lip. It is best treated or improved with cessation of oral contraceptives, intense pulse light lasers, hydroquinone or agents such as Cosmelan. Botox has no effect on melasma. Botox is a neurotoxin that will improve dynamic wrinkles by relaxing or temporarily paralyzing muscles.

Sanjay Grover, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 245 reviews

Botox has no effect on melasma

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Thank you for your question. Botox will have absolutely NO effect on melasma or any other pigmentation issues in any way. Feel safe using Botox if you have a pigmentation issue!

Don Mehrabi, MD
Beverly Hills Dermatologist

Botox does not affect melasma

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To my knowlege, Botox does not lighten or darken skin pigmentation with respect to melasma. Botox injections can rarely cause temporary brown spots in persons of color at injection sites, but this is totally unrelated to melasma.

Bryan K. Chen, MD
San Diego Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.