Melasma is a common disorder where there is increased pigmentation of the skin, usually of the sun exposed areas of the face. It is more common in women with darker skin tones, and women who are on birth control pills, taking hormone replacement, or pregnant. It is also seen in certain diseases involving the hormones.
The exact causes are unknown, but there are genetic factors at work, and melasma is made worse by exposure to sunlight. It is very important for people with melasma to use sunscreen.
Creams that contain lightening agents (for example hydroquinone, kojic acid, and retinoids) may be helpful in treating melasma, as may chemical peels or laser therapy. However, melasma is very difficult to treat and returns easily, especially after exposuer to sunlight.