What is Melasma and Why it Effects Mostly Women

Melasma is a medical condition that causes darkened patches on the skin. These darkened areas may be grayish-brown or brown. They typically appear on the forehead, nose, upper lip, cheeks, or chin but may also present on the arms and neck. Though pregnant women often present with melasma, it isn’t limited to pregnancy. Women of all ages and stages of life can develop melasma.

What is Melasma?

An estimated six million people in the United States have melasma. The condition doesn’t pose any health risks and won’t harm the skin or surrounding areas. Unfortunately, it can cause severe emotional distress. The dark patches caused by melasma can take decades to go away on their own. 

Those with darker skin are more likely to develop melasma because the skin naturally produces more pigment. Everyone has cells that produce pigment. Melasma occurs when the pigment-producing cells become hyperactive and produce too much pigment in some areas of the skin. This is why freckles occur; however, melasma patches are much larger.

The Reasons Melasma Occurs

Though melasma can occur for many reasons, there are two main causes of melasma: sun exposure and hormones.

Sun exposure

The pigment cells in the skin are responsible for your sun-kissed tan. This is because the UV rays in the sunlight cause the pigment cells to become activated. When these cells become activated they may begin producing too much pigment in the form of melasma patches. 

Those who have melasma or who have recently recovered from melasma must be diligent about using sunscreen and wearing protective clothing. Because heat and visible light can also trigger the cells to activate, sunscreen isn’t always enough. Those with the condition should try to avoid long periods in the sun if possible.


Fluctuations in hormones, which often occur during ovulation, menstruation, and pregnancy, can cause melasma. Taking or stopping birth control pills and undergoing hormone replacement therapy can also trigger the cells to activate. Often, these cells are activated by hormones. Once too much time is spent in the sun, the melasma patches appear.

Why Women are Affected Most Often by Melasma

Women make up over 90 percent of all melasma cases while men are diagnosed less than 10 percent of the time. Men typically develop melasma because of sun exposure. Women are more affected by melasma because of hormone fluctuation. This may be why women ages 20 to 50 are most likely to develop melasma as these are the years where hormones fluctuate the most.

Treatment Options for Melasma

Though melasma can fade away on its own, this can take many years to occur. In some women, the dark patches never fade away. If you have melasma, you shouldn’t have to suffer from melasma needlessly for years. Many treatment options can be recommended by a dermatologist. Effective melasma treatment in Kansas City, for example, usually involves one or more of the following options:

Tretinoin and corticosteroids, which can reduce skin inflammation and lighten the dark patches with a gel, lotion, or cream that is regularly applied

Hydroquinone, which lightens the skin by inhibiting the skin’s ability to produce pigment

Azelaic acid, which sheds dead skin cells and promotes healthy skin cells to grow

Kojic acid, which lightens the skin and exfoliates any dead skin cells

These topical treatments are often the first things that are recommended. If these topical treatments don’t work, your dermatologist may recommend different options. These options may include:

  • Chemical peels that can remove several layers of the pigmented skin at once
  • Microneedling in combination with topical creams to lighten the skin
  • Laser treatment is often a last resort but has been highly successful in lightening severely dark melasma patches

If you have melasma, there is no need to deal with the frustration and embarrassment that some feel because of the condition. Talk with your dermatologist to determine what melasma treatment may be right for you. Make sure to avoid the sun, wear a sunscreen with at least an SPF of 35 and wear a hat and light, protective clothing to prevent the melasma from worsening during treatment.

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