Melasma / Freckles

Melasma is a common pigmentation disorder that causes brown or gray patches to appear on the skin, primarily on the face.

The most common areas for melasma to appear on the face include:

  • the bridge of the nose
  • the forehead
  • the cheeks
  • the upper lip

Melasma may also appear on other areas of the body, especially those exposed to a lot of sunlight. These areas may include:

  • the forearms
  • the neck
  • the shoulders

According to the American Academy of Dermatology, only 10 percent of all cases of melasma occur in men. Women with darker complexions and who are pregnant are at greater risk of developing melasma.

Causes

Doctors do not fully understand why melasma occurs. It may be due to the malfunction of the melanocytes (the color-making cells) in the skin, causing them to produce too much color.

As a result, people with darker skin tones are more likely to develop melasma, as they have more melanocytes than people with lighter skin.

Potential triggers for melasma include:

  • changes in hormones during pregnancy (chloasma), hormone treatment, or while taking birth control pills
  • sun exposure
  • certain skin care products, if they irritate a person’s skin

Also, there may be a genetic component to melasma, as people whose close relatives have experienced melasma are more likely to develop it themselves.

Symptoms

Apart from changes in appearance, melasma does not cause any physical symptoms.

The primary symptom of melasma is the development of discolored patches of skin. While it does not cause any other physical symptoms, some people find the appearance of these patches bothersome.

The most common area for patches of melasma to appear is the face. Common locations include the upper lips, bridge of the nose, cheeks, and forehead.

Less commonly, a person may also have patches on their arms and neck.

Diagnosis

Dermatologists find most cases of melasma easy to diagnose during a visual examination. However, since melasma can resemble other skin conditions, a dermatologist may take a small biopsy during the initial visit.

A biopsy involves removing a very small portion of the skin for further examination in a laboratory.

A doctor may also use a device called a Wood’s light to look more closely at the skin.