One of the most common skin concerns we see in our patients at Florida Dermatology and Skin Cancer Centers is melasma. Many patients come to us feeling frustrated or self-conscious about dark patches on their face, unsure of what’s causing them or how to make them go away. Some notice that the spots darken in the sun no matter how careful they are with sunscreen. Others see changes during pregnancy or after starting new medications. Although melasma doesn’t hurt or itch, and it is a cosmetic concern, we understand the emotional impact can still be challenging.
The good news is, melasma is a common condition, and you are not alone if you’re dealing with it. With the right knowledge, change in daily habits, and professional guidance, melasma can be managed.
Keep reading to learn more about what melasma is, and how you can handle all it brings with confidence.
What is Melasma?
Melasma is a skin condition that causes light or dark brown, or blue-gray patches to appear on the skin. These patches are usually flat and darker than the surrounding skin and sometimes resemble freckle-like spots. Sometimes people also mistake melasma for sun damage. While melasma can technically appear anywhere, it most often affects the face, especially the cheeks, forehead, bridge of the nose, upper lip, and chin. In some cases, we also see it on areas exposed more to the sun, such as the forearms or neck.
It’s important to know that melasma is not harmful to your health. It doesn’t become malignant, and it doesn’t cause pain or itching. But for many of our patients, the biggest challenge is how visible it can be and the effect it has on self-confidence.
What Causes Melasma?
We don’t always know exactly why one person develops melasma while another doesn’t, but we do know that factors like hormones, genetics, and sun exposure play a big role. People with fair skin are less likely to be affected by melasma than people with darker brown skin, or those who tan well. Women are generally more likely to get melasma over men, with pregnancy, oral contraceptives and hormones being a common cause.
With your skin being the largest organ in your body, think of it as your body’s shield of protection. It protects everything underneath, including your bones, muscles and organs, from the outside world. Your skin has three main layers: the epidermis (outer layer), the dermis (middle layer), and the hypodermis (the deepest layer). In the epidermis, you’ll find cells called melanocytes. These cells make a natural pigment called melanin, which gives your skin its color.
When your skin is exposed to sunlight, heat, or even changes in hormones, the melanocytes respond by producing more melanin. That’s why your skin may darken, tan, or develop patches of pigment over time. In conditions like melasma, these pigment-producing cells become extra active, creating more melanin than usual in certain spots.
Common Triggers of Melasma
One of the questions we often hear is: “What makes my melasma flare up?” While triggers can vary from person to person, some of the most common include:
- Sun exposure: Even a little sun can make melasma darker. UV rays are the number one trigger, which is why the application of sunscreen is so important.
- Hormonal changes: Pregnancy, birth control, or hormone therapy can all aid in the formation of melasma. Melasma is sometimes called “the mask of pregnancy.”
- Genetics: If melasma runs in your family, you may be more likely to develop it.
- Certain products or medications: Some cosmetics or medications can increase sun sensitivity.
- Heat and light: Not just sunlight, but even heat from hot weather, cooking, or tanning beds can sometimes worsen melasma.
Can Melasma Be Cured?
This is another common question we hear. The answer is: there isn’t a permanent cure for melasma. However, the condition can be managed very effectively. Melasma may fade on its own (especially after pregnancy or if certain medications are stopped), but it often returns if triggers are present.
The goal of treatment is to lighten the dark patches and keep flare-ups under control. With consistency and patience, many of our patients see significant improvement.
Treatment Options for Melasma
Because every patient’s skin is unique, treatment should be tailored to you. Some of the options we may recommend at FLDSCC include:
- Topical creams: Prescription-strength creams containing ingredients like hydroquinone, tretinoin, or corticosteroids can help fade dark spots.
- Other topical agents: Glycolic acid, salicylic acid, niacinamide and other cosmeceuticals for skin lightening can help even skin tone.
- Chemical peels: These exfoliate the top layer of skin to reduce discoloration.
- Sun protection: This is the foundation of every treatment plan. Daily broad-spectrum sunscreen (SPF 30 or higher) is essential to protect skin from sun damage and prevent worsening of melasma.
The best approach is often a combination of treatments, adjusted over time based on how your skin responds.
Can You Prevent Melasma?
While we can’t always prevent melasma, we can take steps to reduce the chances of flare-ups. Here are some of the recommendations we give our patients:
- Apply a broad-spectrum sunscreen with a SPF 30 or higher every single day, rain or shine.
- Reapply sunscreen every two hours.
- Wear wide-brimmed hats and seek shade whenever possible.
- Avoid tanning beds and unnecessary sun exposure.
- Use gentle skin care products to avoid irritating your skin.
Even small daily habits add up and make a big difference in keeping melasma under control.
At-Home Remedies vs. Professional Care
We know it’s tempting to try home remedies or over-the-counter creams you see online. Unfortunately, many of these don’t live up to their promises, and some can even make melasma worse by irritating the skin.
That’s why it’s best to work with a dermatologist. Together, we can figure out what’s really driving your melasma and choose safe, effective treatments that fit your skin type and lifestyle.
Diagnosis and Outlook
If you suspect you have melasma, the first step is scheduling an appointment with a trusted dermatology office. Most of the time, melasma can be diagnosed with a simple skin exam in the office. Occasionally, we may recommend additional tools or tests to rule out other skin conditions.
Once we confirm melasma, we’ll create a personalized treatment plan that takes into account your skin, your triggers, and your goals. Melasma can be stubborn, and it may not completely go away, but with the right care, the condition can be greatly improved and managed long-term. Many of our patients see real changes in their skin tone and feel much more confident once they have a plan in place.
If you’ve been struggling with dark patches on your skin, know that you’re not alone and that help is available. Melasma can be frustrating, but it’s also very common and treatable. Our dermatology team is here to guide you with safe, effective options tailored just for you. If you’re ready to take the next step toward clearer, more even skin, we’d be happy to see you for a consultation.
About Us
FLDSCC’s team of providers are experts in diagnosing and treating skin cancers; skin conditions and diseases such as eczema, rosacea, dry skin, rashes, and warts; and chronic skin diseases and infections, while simultaneously tackling aging skin, wound care, and a multitude of other skin, hair, and nail concerns.
Several FLDSCC providers are fellowship-trained in Mohs micrographic surgery, an effective state-of-the-art treatment for most types of skin cancers. Mohs surgery involves minimal discomfort and encourages the greatest preservation of healthy tissue, which means less risk of scarring and superior cosmetic results.
FLDSCC has many convenient locations throughout the state. For more information, visit www.fldscc.com, or call (855) FLD-SKIN.
