Table of ContentsView AllTable of ContentsFactsSymptomsCausesWhen to See a DoctorManagement and TipsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Facts
Symptoms
Causes
When to See a Doctor
Management and Tips
Frequently Asked Questions
This article is part ofHealth Divide: Skin Conditions and Darker Skin, a destination in our Health Divide series.
As with otherdermatologicaland medical issues, there are specific considerations unique to darker skin types when it comes to the treatment and management of melasma.For people with darker skin, it’s important to understand the basics of how this condition affects you, as well as what can be done about it. This article covers the causes, symptoms, risk factors, diagnosis, as well as medical and at-home management options for melasma.
Zoe Hansen / Verywell
Inequities in CareAs with other aspects of medical care, there are racial inequities when it comes to melasma treatment and management. This arises for several reasons, including:Lack of diversity among providers:People with darker skin are underrepresented in the medical field, resulting in systemic gaps in treatment.Insufficient trials:There’s insufficient representation of people with darker skin inclinical trialsand medical research, which contributes to a lack of knowledge about health conditions impacting them.Inadequate training:Medical and nursing schools often don’t do enough in the way of training of their students and residents in dermatological diseases most common in people with darker skin. This allows racial and cultural gaps to proliferate in health care.Being aware of these potential gaps is critical in the medical setting. It’s important to seek competent providers, communicate, and advocate for yourself as you seek care.
Inequities in Care
As with other aspects of medical care, there are racial inequities when it comes to melasma treatment and management. This arises for several reasons, including:Lack of diversity among providers:People with darker skin are underrepresented in the medical field, resulting in systemic gaps in treatment.Insufficient trials:There’s insufficient representation of people with darker skin inclinical trialsand medical research, which contributes to a lack of knowledge about health conditions impacting them.Inadequate training:Medical and nursing schools often don’t do enough in the way of training of their students and residents in dermatological diseases most common in people with darker skin. This allows racial and cultural gaps to proliferate in health care.Being aware of these potential gaps is critical in the medical setting. It’s important to seek competent providers, communicate, and advocate for yourself as you seek care.
As with other aspects of medical care, there are racial inequities when it comes to melasma treatment and management. This arises for several reasons, including:
Being aware of these potential gaps is critical in the medical setting. It’s important to seek competent providers, communicate, and advocate for yourself as you seek care.
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Facts About Melasma on Darker Skin
As with other dermatological conditions, there are some popular misconceptions when it comes to melasma. The key to living with and managing it is to separate the facts from the fiction about this condition.
Melasma
It Can Affect All Skin Types
Because it most often arises in people with darker skin, some think of melasma as exclusive to non-white populations. Indeed, a vast majority of cases are seen in these populations, and South America and Central America, Southeast Asia, northern Africa, and the Middle East have higher rates than other regions.
However, this disorder can also arise in those with lighter skin.
Melanocytes and Melanin
Fundamentally, melasma is a disorder of themelanocytes, which are skin cells that affect pigmentation. These cells are primarily found in the basal layer of theepidermis, or outer layer of skin.
Julie Bang / Verywell
People may confuse melanocytes with what they produce and store: melanin. This is a brown pigment that gives skin its pigmentation, so those with darker skin have higher amounts of it.In melasma, these cells are hyperactive, causing spotting and discoloration.
Melasma in Pregnancy
While melasma doesn’t only affectpregnant people, the hormonal changes that occurduring pregnancymay set off this pigmentation disorder. This is why this condition is sometimes referred to popularly as “the mask of pregnancy.”If you’re expecting—and especially if you’re a person with darker skin—you’re at a much higher risk of experiencing melasma.
Melasma Can Fade
In many cases, melasma can fade on its own, without treatment. For instance, people who are pregnant may find the discoloration goes away after delivery due to hormonal shifts in the body.Additionally, since sun exposure can lead to melasma, patches and spots can get darker during the summer months. In cooler times of the year, the melasma will be less prominent.
Melasma Is Not Cancerous
Unlike some other dermatological conditions, melasma is not a sign ofskin cancer, and it doesn’t increase the risk of developing it.However, significant discoloration is associated with cancer formation and can look similar, which is why medical attention is necessary.
More Than Melanin: Skin Cancer Is Still a Risk for the Black Community
Melasma Likely Isn’t Associated With Thyroid Disease
Melasma isn’t reliably associated with other clinical conditions or diseases and generally doesn’t have complications. While some studies have found it associated withthyroid disease, subsequent research hasn’t found higher rates in people with the condition.
Symptoms of Melasma on Darker Skin
Appearance
Since melasma is a disorder of the melanocyte cells that regulate pigmentation, it most prominently affects the appearance of the skin. If you have darker skin, this condition appears as brown, gray, or blue patches or dots.Sometimes, the discolored can become reddish brown due to the underlying blood vessels that can sometimes be more prominent in melasma.
Reproduced with permission from © DermNet New Zealandwww.dermnetnz.org2023.
Location
Melasma usually develops on parts of the skin that get more sun exposure, and it’s categorized based on its location on the body. Here’s a breakdown:
Causes of Melasma on Darker Skin
Risk Factors
Researchers have identified several risk factors for developing melasma. The following groups are more likely to develop this condition:
The Role of HormonesThe hormones estrogen and progesterone are involved in most melasma cases. Fluctuations in their levels are known to trigger attacks, as occurs in the following:PregnancyEstrogen (hormone) therapyBirth control useMenopause(marking 12 consecutive months with no menstrual period)
The Role of Hormones
The hormones estrogen and progesterone are involved in most melasma cases. Fluctuations in their levels are known to trigger attacks, as occurs in the following:PregnancyEstrogen (hormone) therapyBirth control useMenopause(marking 12 consecutive months with no menstrual period)
The hormones estrogen and progesterone are involved in most melasma cases. Fluctuations in their levels are known to trigger attacks, as occurs in the following:
When to See a Healthcare Provider
While melasma, itself, isn’t dangerous, spots or patches of discoloration can be signs of other conditions, both benign and problematic. These include:
Medically speaking, then, it’s crucial to get skin changes examined to ensure you don’t have a more serious disease. In addition, since melasma affects your appearance, it can impact your confidence and sense of self-esteem. It’s worth exploring your options in these cases, too.
Physical Examination
The diagnosis of melasma involves several kinds of assessments, and it may be more challenging to identify in those with darker skin. This may involve:
Questions to Ask
Making sure you’re informed about your condition and able to advocate for yourself is essential for the management of melasma. If you do see a healthcare professional such as adermatologist(doctor specializing in conditions of the skin, hair, and nails) about your case, consider asking questions such as:
Management and Skin Care Tips
While melasma resolves on its own is some cases, it often persists, and there’s no outright cure. However, along with medical treatments and medications, there’s a lot you can do to manage this condition. This will mean mixing and matching strategies to find what works for you.
Treatment Options
The first line of managing melasma involves developing prevention and home-management strategies, including avoiding certain triggers. Limit your exposure to or avoid the following:
Choosing the Best Type of Bar Soap for Your Skin
Along with the above, there are a number of medications that can be prescribed to help. These include:
Lastly, other medical treatments may help, especially when paired with medications. These include:
Does Dark Skin Prolong Melasma Treatment?Those with darker skin are more likely to develop melasma. In addition, melasma is more challenging to treat in darker skin types. Highly pigmented skin types often require stronger topical therapies and may take a longer time to get results.
Does Dark Skin Prolong Melasma Treatment?
Those with darker skin are more likely to develop melasma. In addition, melasma is more challenging to treat in darker skin types. Highly pigmented skin types often require stronger topical therapies and may take a longer time to get results.
How Melasma Is Treated
Summary
Though this condition is painless and doesn’t cause complications, it can resemble more dangerous issues and affect your appearance. Melasma is a chronic condition, but there are treatments available. Treatment often involves mixing strategies that range from using certain medications to working to prevent the onset to medical procedures, such as chemical peels.
It’s important to be able to advocate for yourself and seek the treatment you need.
Know Your Rights as a Patient in the American Healthcare System
A Word From Verywell
While melasma is one of the most common skin pigmentation disorders, the medical community has some catching up to do. If you have darker skin, it’s important not only to seek medical care but also to be your own advocate. By being proactive, you’ll set yourself on the road to recovery from melasma.
Frequently Asked QuestionsLifestyle factors can impact melasma, and, alongside othertopical treatments, a number of vitamins and minerals may help you manage it, including:Folate:This is the natural form of vitamin B9, found in supplements, as well as citrus, broccoli, kale, liver, and nuts, among others.Vitamin C:Vitamin C promotes the healing and repair of skin. It’s found in citrus, bell peppers, strawberries, as well as certain vegetables, like Brussels sprouts, cabbage, and others.Vitamin E:Another vitamin that helps promote skin health is vitamin E, which is heavy in foods like sunflower seeds, soybeans, wheat germ, almonds, peanuts, and leafy green vegetables (such as collard greens and kale).Zinc:Found in oysters, most kinds of nuts, whole grains, beans, and some dairy products, zinc may also be helpful in taking on melasma.Learn MoreVitamins for Skin HealthMost cases of melasma do fade within three months, though they can recur in response to sun exposure and other factors. When the condition is related to hormonal shifts, as in pregnancy or due to birth control use, it resolves as levels normalize. For others, however, the condition can be difficult and chronic, requiring treatment.Learn MoreWhat Are Skin Pigmentation Disorders?While chemical peels for melasma can be very effective, this procedure comes with a few risks. Inflammation and pain can occur in treated areas, with permanent scarring occurring in some cases. Notably, some types of melasma aren’t treatable this way—and other treatments should be attempted first.Learn MoreWhat to Expect From a Salicylic Acid Peel
Lifestyle factors can impact melasma, and, alongside othertopical treatments, a number of vitamins and minerals may help you manage it, including:Folate:This is the natural form of vitamin B9, found in supplements, as well as citrus, broccoli, kale, liver, and nuts, among others.Vitamin C:Vitamin C promotes the healing and repair of skin. It’s found in citrus, bell peppers, strawberries, as well as certain vegetables, like Brussels sprouts, cabbage, and others.Vitamin E:Another vitamin that helps promote skin health is vitamin E, which is heavy in foods like sunflower seeds, soybeans, wheat germ, almonds, peanuts, and leafy green vegetables (such as collard greens and kale).Zinc:Found in oysters, most kinds of nuts, whole grains, beans, and some dairy products, zinc may also be helpful in taking on melasma.Learn MoreVitamins for Skin Health
Lifestyle factors can impact melasma, and, alongside othertopical treatments, a number of vitamins and minerals may help you manage it, including:Folate:This is the natural form of vitamin B9, found in supplements, as well as citrus, broccoli, kale, liver, and nuts, among others.Vitamin C:Vitamin C promotes the healing and repair of skin. It’s found in citrus, bell peppers, strawberries, as well as certain vegetables, like Brussels sprouts, cabbage, and others.Vitamin E:Another vitamin that helps promote skin health is vitamin E, which is heavy in foods like sunflower seeds, soybeans, wheat germ, almonds, peanuts, and leafy green vegetables (such as collard greens and kale).Zinc:Found in oysters, most kinds of nuts, whole grains, beans, and some dairy products, zinc may also be helpful in taking on melasma.
Lifestyle factors can impact melasma, and, alongside othertopical treatments, a number of vitamins and minerals may help you manage it, including:
Learn MoreVitamins for Skin Health
Most cases of melasma do fade within three months, though they can recur in response to sun exposure and other factors. When the condition is related to hormonal shifts, as in pregnancy or due to birth control use, it resolves as levels normalize. For others, however, the condition can be difficult and chronic, requiring treatment.Learn MoreWhat Are Skin Pigmentation Disorders?
Most cases of melasma do fade within three months, though they can recur in response to sun exposure and other factors. When the condition is related to hormonal shifts, as in pregnancy or due to birth control use, it resolves as levels normalize. For others, however, the condition can be difficult and chronic, requiring treatment.
Learn MoreWhat Are Skin Pigmentation Disorders?
While chemical peels for melasma can be very effective, this procedure comes with a few risks. Inflammation and pain can occur in treated areas, with permanent scarring occurring in some cases. Notably, some types of melasma aren’t treatable this way—and other treatments should be attempted first.Learn MoreWhat to Expect From a Salicylic Acid Peel
While chemical peels for melasma can be very effective, this procedure comes with a few risks. Inflammation and pain can occur in treated areas, with permanent scarring occurring in some cases. Notably, some types of melasma aren’t treatable this way—and other treatments should be attempted first.
Learn MoreWhat to Expect From a Salicylic Acid Peel
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ogbechie-Godec O, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb). 2017;7(3):305-318. doi:10.1007/s13555-017-0194-1Espinosa M, Lio P.Dermatologic disparities: Essential considerations in patient care. Practical Dermatology.Nijhawan RI, Sharon JE, Woolery-Lloyd H.Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States?Journal of the American Academy of Dermatology. 2008;59(4):615-618. doi:10.1016/j.jaad.2008.06.024Cichorek M, Wachulska M, Stasiewicz A, Tymińska A.Skin melanocytes: Biology and development.Postepy Dermatol Allergol. 2013;1:30-41. doi:10.5114/pdia.2013.33376American Academy of Dermatology Association.Melasma: diagnosis and treatment.Cleveland Clinic.Melasma.Pandya A.Melasma. Skin of Color Society.Oakley A.Melasma. DermNet NZ.Handel A, Miot L, Miot H.Melasma: A clinical and epidemiological review.An Bras Dermatol. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063Handel AC, Lima PB, Tonolli VM, Miot LD, Miot HA.Risk factors for facial melasma in women: A case-control study.Br J Dermatol. 2014;171(3):588-594. doi:10.1111/bjd.13059
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ogbechie-Godec O, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb). 2017;7(3):305-318. doi:10.1007/s13555-017-0194-1Espinosa M, Lio P.Dermatologic disparities: Essential considerations in patient care. Practical Dermatology.Nijhawan RI, Sharon JE, Woolery-Lloyd H.Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States?Journal of the American Academy of Dermatology. 2008;59(4):615-618. doi:10.1016/j.jaad.2008.06.024Cichorek M, Wachulska M, Stasiewicz A, Tymińska A.Skin melanocytes: Biology and development.Postepy Dermatol Allergol. 2013;1:30-41. doi:10.5114/pdia.2013.33376American Academy of Dermatology Association.Melasma: diagnosis and treatment.Cleveland Clinic.Melasma.Pandya A.Melasma. Skin of Color Society.Oakley A.Melasma. DermNet NZ.Handel A, Miot L, Miot H.Melasma: A clinical and epidemiological review.An Bras Dermatol. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063Handel AC, Lima PB, Tonolli VM, Miot LD, Miot HA.Risk factors for facial melasma in women: A case-control study.Br J Dermatol. 2014;171(3):588-594. doi:10.1111/bjd.13059
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ogbechie-Godec O, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb). 2017;7(3):305-318. doi:10.1007/s13555-017-0194-1Espinosa M, Lio P.Dermatologic disparities: Essential considerations in patient care. Practical Dermatology.Nijhawan RI, Sharon JE, Woolery-Lloyd H.Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States?Journal of the American Academy of Dermatology. 2008;59(4):615-618. doi:10.1016/j.jaad.2008.06.024Cichorek M, Wachulska M, Stasiewicz A, Tymińska A.Skin melanocytes: Biology and development.Postepy Dermatol Allergol. 2013;1:30-41. doi:10.5114/pdia.2013.33376American Academy of Dermatology Association.Melasma: diagnosis and treatment.Cleveland Clinic.Melasma.Pandya A.Melasma. Skin of Color Society.Oakley A.Melasma. DermNet NZ.Handel A, Miot L, Miot H.Melasma: A clinical and epidemiological review.An Bras Dermatol. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063Handel AC, Lima PB, Tonolli VM, Miot LD, Miot HA.Risk factors for facial melasma in women: A case-control study.Br J Dermatol. 2014;171(3):588-594. doi:10.1111/bjd.13059
Ogbechie-Godec O, Elbuluk N.Melasma: An up-to-date comprehensive review.Dermatol Ther (Heidelb). 2017;7(3):305-318. doi:10.1007/s13555-017-0194-1
Espinosa M, Lio P.Dermatologic disparities: Essential considerations in patient care. Practical Dermatology.
Nijhawan RI, Sharon JE, Woolery-Lloyd H.Skin of color education in dermatology residency programs: Does residency training reflect the changing demographics of the United States?Journal of the American Academy of Dermatology. 2008;59(4):615-618. doi:10.1016/j.jaad.2008.06.024
Cichorek M, Wachulska M, Stasiewicz A, Tymińska A.Skin melanocytes: Biology and development.Postepy Dermatol Allergol. 2013;1:30-41. doi:10.5114/pdia.2013.33376
American Academy of Dermatology Association.Melasma: diagnosis and treatment.
Cleveland Clinic.Melasma.
Pandya A.Melasma. Skin of Color Society.
Oakley A.Melasma. DermNet NZ.
Handel A, Miot L, Miot H.Melasma: A clinical and epidemiological review.An Bras Dermatol. 2014;89(5):771-782. doi:10.1590/abd1806-4841.20143063
Handel AC, Lima PB, Tonolli VM, Miot LD, Miot HA.Risk factors for facial melasma in women: A case-control study.Br J Dermatol. 2014;171(3):588-594. doi:10.1111/bjd.13059
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