Do You Know What Really Causes Melasma?

Photo Credits: Tanner Productions/Corbis

In your reproductive years, it's not uncommon to experience all sorts of changes to your body and skin. So if you've recently noticed patchy brown, tan, or blue-gray facial skin discoloration, you may be experiencing what is known as “the mask of pregnancy,” or melasma. This skin condition is one of the harder types of hyperpigmentation to correct because it is tied to estrogen and progesterone (found in birth control pills) and can affect the deep dermal layers of the skin. Learn more about what's causing your melasma below.

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How Severe is Your Melasma?

One of the easiest ways to determine how deep your melasma goes is by stretching the skin. “If you stretch out the discolored portion and it appears lighter than when the skin is at rest, then the hyperpigmentation is superficial,” says Beverly Hills, CA, dermatologist Zein E. Obagi, MD. “If it’s darker, then the pigmentation lies in the dermal layers.”

The Role of Estrogen

Hormones play a big role in how hyperpigmentation affects the skin, especially estrogen. “When estrogen levels are elevated, either from pregnancy or birth control pills, additional melanin is produced,” says Dr. Obagi. “With all this extra melanin floating in the skin, it settles as dark deposits, which results in melasma.” Some who experience hormone-induced hyperpigmentation, which can also be caused by progesterone, notice that the discoloration ends once hormone levels stabilize; others need medical treatment to even out their skin.

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What it Looks Like:

Melasma appears as dark patches on the skin. “You usually find it on the sides of the face, the forehead, the upper lip, the chin and the sides of the neck,” says New York City dermatologist Doris Day, MD. Mild melasma appears as faint brown splotches that are rather small, but full-blown melasma surfaces as patches of light brown skin with irregular borders.

Why it Occurs:

The true cause of melasma is still not known, but most experts agree that it is triggered by excess melanocytes, which produce too much pigment in the skin. “Estrogen is at the heart of the problem but the sun is a catalyst too,” says Reston, VA, dermatologist Dr. Syed Amiry. “The combination of the two causes unwanted pigment to be produced, resulting in dark patches because of an imbalance of pigment in certain areas.” Melasma can occur at either the surface level (superficial melasma) or in the deeper layers of skin (dermal or deep melasma), giving it more of a spread-out appearance. “Melasma is more apparent during and after periods of sun exposure and less obvious in the winter months,” says Dr. Day. Although melasma is not hereditary, there is some genetic tie to it.

Who it Affects:

Melasma mostly affects pregnant women, but you don’t have to be pregnant or have had a child to experience it. “In pregnancy, melasma usually appears in the second or third trimester,” says New York City dermatologist Doris Day, MD. It’s also more common in those with dark skin tones, like Hispanics and Asians.

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  • TA
    Posted on

    Sheer cover didn't cover - nothing does. Still researching - think linked to estrogen but very little research on this

  • Karen
    Posted on

    VONNIE... - if yours has spread that quickly it could be fungal based. Some women have cleared up their face by applying athletes foot cream(!); it has something to do with candida I think? My melasma has progressed gradually over the past few years, and I think if it's not pregnancy related then that's how it tends to develop. Google the athletes foot cream and you'll find loads of info - got to be worth a try....

  • Posted on

    The First thing for all Melasma patients to understand is the huge importance of sun protection year around - Melasma is attracted to light - The moment you are exposed to the sun for 2 minutes your condition will come back - could even return worse than before - Since its summer in the USA, I recommend using L-Ascorbic Vitamin C 15% every morning with your SPF 45. In the evening I recommend either the brightening or lightening serum - It can be purchased at - Once you have controlled your pigmentation you can use the lightening or brightening serums as a maintenance - But both Vitamin C and SPF are for life. Any treatments are simply putting the melanocytes in a dormant state, therefore not completely getting rid of them but treating so they are not visible. Thats why your SPF is curtail. Have a happy Summer and enjoy proper skincare and a fabulous season.

  • Vonnie
    Posted on

    Nothing seems to work, found one person (Brook Burke) who was on a makeup commercial (sheer cover studio) that has melisma and she claims it covers it up so I will try an see if it works, I must note that I got these ugly stains on my face at age 58 and I'm almost never in the sun...took two weeks for it to cover my face, even my eyebrows. It makes me feel so ugly.

  • Mtantillo
    Posted on

    Okay, so list some products or actionable steps to reduce the appearance of Melasma please.

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