What Causes Melasma?

Is there anything preventative that can be done to keep melasma from developing?

Doctor Answers 4

Causes and treatments for melasma

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Melasma is caused by melanocyte hyperstimulation that is likely induced by genetic factors, hormones, and sun.  I begin all of my melasma patients with Melaquin AM and Melaquin PM creams, followed by MelaPeel.



Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Melasma involves some important control factors

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Melasma is normally a hormonal issue. Some skin discolorations are caused by over exposure to sun or heat (you can get hyperpigmentation from standing over a hot stove - this is sometimes a problem for those who work in restaurant kitchens)

No matter what the root cauase of your melasma, being in the sun without sunscreen will make it worse.

Melasma starts deep in the skin so a "fast" resolution is never as fast as someone hopes for. Stopping the production of excess melanin is a vital step in controlling melasma. Products that help speed up cell turnover are useful in assisting the sloughing of the skin cells which contain excess melanin.

Cosmelan is a multi-ingredient nonhydroquinone product system that has proven results in blending out the appearance of brown spots. It helps, though sometimes can't perform the miracle you might hope for. Even with this treatment, sunscreen is a must. Obagi products can be effective as they incorporate hydroquinone and along with a retinoid, hasten the turnover of affected skin.

Birth control pills are indeed a well known culprit as the chemically induced hormone changes set up the hyperactivity of melanin producing cells (as does pregnancy and sometimes menopause). I'm not a gynecologist so can't offer specific advice on particular b/c products, but your own doctor may know of ones that aren't as catalytic in causing melasma.

Sun protection at all times is crucial. Wear a hat when you go out. It can become your signature and will help forestall premature wrinkling along with keeping your skin better color balanced.

You'll probably see some minor improvement with over the counter products along with sunscreen but likely melasma that has taken hold is best treated by a dermatologist. If you're of Asian or Middle Eastern heritage, for sure see a dermatologist before embarking on a self-managed attack on melasma. Some drug store or internet advertised products can make things worse.

I wish I could offer you a fast, guaranteed permanent fix for melasma, but there isn't one. Find a board certified dermatologist and see what is recommended. Again, sun protection all the time is extremely important.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Melasma is related to sun and hormonal changes

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Melasma is a hereditary skin condition that appears to be triggered by a combination of the sun and changes in hormones. It is espeically common with pregnancy or when patients are taking birth controll pills. It also can appear suddenly with no underlying cause.If you have been diagnosed with melasma, remember to wear a daily physical sun screen to protect your skin from UVA and UVB rays.


Miriam Hanson, MD
Austin Dermatologist

No sun equals no melasma

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Patients may have many predisposing factors for the development of melasma but the universal trigger is the sun.  Although difficult, it is very possible to get absolutely no sun on the face.  This means wearing broad brimmed hats and sunscreen at all times when outside during the day. If melasma does develop, seek the help of a board certified dermatologist for a diagnosis, further workup if deemed necessary and a treatment regimen.

Anthony Perri, MD
Houston 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.