Frequently asked questions

Melasma is a common skin condition that causes flat, tan, brown or gray-brown patches, usually on the cheeks, forehead, nose, chin or upper lip. It happens when pigment cells become more active, often in response to sun, visible light, heat and hormones. It's harmless and not contagious, but it can be long-lasting.

Melasma is more common in women and in people with medium to deep skin tones, though anyone can get it. Learn the triggers and who gets it in What is melasma?

Melasma is caused by pigment cells that become more active in response to certain triggers, mainly sunlight, visible light, heat and hormones. Pregnancy, birth control pills and a family history of melasma all raise the odds. Researchers still don't fully understand why some people react to these triggers and others don't.

Some medicines that make skin more sensitive to sun, thyroid conditions and tanning beds have also been linked to melasma. Daily broad-spectrum sunscreen is the most important habit. Read more in What is melasma? Causes, triggers and who gets it.

Melasma is one type of hyperpigmentation, but not all hyperpigmentation is melasma. Hyperpigmentation is the umbrella term for any skin that's darker than the area around it. Melasma forms even, often symmetrical patches linked to sun, heat and hormones, while other types include sun spots and the marks left after breakouts (PIH).

Telling them apart matters because the care plan is different. See Melasma vs sun spots vs hyperpigmentation: how to tell, and ask a dermatologist if you're not sure.

No, melasma and sun spots are different. Sun spots are small, well-defined brown spots that build up after years of UV exposure, often on the face, hands and chest. Melasma forms larger, blotchy patches, usually on both sides of the face, and is linked to hormones, heat and visible light as well as sun.

Both get darker with sun, so daily broad-spectrum SPF 30 or higher matters for either one. For more ways to tell them apart, read Melasma vs sun spots vs hyperpigmentation.

Melasma in pregnancy often starts in the second or third trimester, though it can appear at any point. Rising estrogen and progesterone seem to make pigment cells more active, so patches can show up on the cheeks, forehead or upper lip, especially after time in the sun. It's common enough to be called the mask of pregnancy.

For some people it goes away in the months after the baby is born. Daily tinted sunscreen, shade and a hat protect your skin in the meantime, and check any new skincare with your doctor while you're pregnant. More in Melasma in pregnancy.

Yes, hormonal birth control, especially the pill, can trigger melasma in some people. The hormones in many contraceptives (estrogen and progestin) can make pigment cells more active, and sun exposure then brings the patches out. Not everyone on birth control gets melasma: genetics, skin tone and sun habits all play a part.

Don't stop your birth control on your own. Talk to your doctor about your options, and wear broad-spectrum SPF every day. Read Can birth control cause dark spots on your face?

Heat may make melasma worse, even without direct sun. Many people notice their patches look darker after cooking over a hot stove, a sauna, hot yoga or a heat wave. Heat is thought to switch on pigment cells and add inflammation, which is why melasma care covers heat as well as UV and visible light.

Cool your skin down after workouts, step back from hot ovens, and keep up daily sunscreen and shade. More in Does heat make melasma worse? Heat, light and SPF.

The best sunscreen for melasma is a broad-spectrum SPF 30 or higher that you'll wear every day, ideally a tinted mineral formula with iron oxides. The tint adds protection against visible light, which can darken melasma, especially on medium to deep skin. Zinc oxide and titanium dioxide filters are often comfortable on sensitive skin.

Apply it generously every morning and reapply every two hours when you're outdoors. Compare the options in Best sunscreen for melasma: tinted, mineral, visible light.

Melasma isn't always permanent, but it is long-term for many people. It can fade on its own when a trigger ends, for example after pregnancy or after stopping birth control pills. For others it lasts for years, and it often comes back with sun exposure, heat or hormonal changes, even after it has settled.

Daily sun protection is the most important habit. If melasma bothers you, a dermatologist can discuss prescription options and in-office procedures, though no approach can promise it won't return. Learn more in What is melasma?

Yes, men can get melasma, though it's much less common than in women. It looks the same: flat, tan to gray-brown patches on the cheeks, forehead, nose or upper lip. In men, sun exposure and a family history tend to be the main triggers, and it's more common in medium to deep skin tones.

Men often skip sunscreen, so daily SPF 30 or higher and a wide-brimmed hat are the most important habits. Read What is melasma? for the triggers and who gets it.

No, melasma isn't dangerous. It's a harmless change in skin color, it isn't cancer and it isn't a sign of skin cancer. It doesn't hurt, and you can't catch it from or pass it to anyone. Its effects are cosmetic, although it can change how you feel about your skin, and that's worth taking seriously.

Any spot that changes in size, shape or color, bleeds, itches or grows needs to be checked by a dermatologist, whether or not you have melasma. Read more in Melasma vs sun spots vs hyperpigmentation.

See a dermatologist when you first notice patches you think are melasma, so they can confirm it, and again if it spreads, darkens despite daily sunscreen or bothers you. A dermatologist can tell melasma apart from other conditions and discuss prescription options and in-office procedures chosen with your skin tone in mind.

Go sooner if any spot changes, bleeds, itches or grows. Read more in What is melasma?, or see Melasma on dark and brown skin.