MelasmaMelasma

Melasma produces brown or gray-brown patches, most often across the cheeks, forehead, bridge of the nose, chin, and upper lip. Frequently called the mask of pregnancy, it develops when melanocytes overproduce melanin in response to hormonal signaling together with ultraviolet and visible light exposure. Between 33% and 50% of people who develop melasma have a family history, pointing to an underlying genetic susceptibility. Unlike the sun spots it can resemble, melasma is chronic and relapsing. It is managed rather than removed. At Wall Street Dermatology, treatment combines topical therapy with laser where the pigment depth makes that appropriate. Dr. Julia Tzu selects wavelengths according to skin type and pigment depth. Improvement is typically visible within about three months of consistent treatment, with ongoing maintenance and daily sun protection built into the plan from the first visit.

4 min read · Last updated: 2026-02-08 · Reviewed by Dr. Julia Tzu , MD, FAAD, FACMS

• Between 33% and 50% of people with melasma report having a family member with the condition [1]
• Sun exposure triggers melanin production and is a primary cause of melasma development and recurrence [3]
• Melasma from pregnancy often fades after delivery, though it may persist in some cases [2]
• Treatments can fade discoloration but cannot make melasma go away permanently [2]

• Brown or gray-brown patches on the face
• Symmetric pattern on both sides of the face
• Patches with well-defined or blurry borders
• Darker patches on cheeks, forehead, nose bridge, chin, and upper lip
• Patches that darken with sun exposure
• Discoloration on forearms or neck (less common)

• Facial discoloration that bothers you and has not settled on its own
• Dark patches that appeared during pregnancy or after starting a hormonal medication
• Patches that have not responded to over-the-counter products
• Uncertainty about whether facial pigment is melasma, sun damage, or something else, given that the three are treated differently
• Interest in reducing the pigmentation with a plan you can maintain
• Discoloration persisting several months after delivery, once the pregnancy-related hormonal shift has passed

Have questions about melasma? Our team is here to help.

• Increased melanin production by melanocytes
• Sun exposure triggering excess pigment production
• Hormonal changes from pregnancy
• Oral contraceptives containing estrogen and progesterone
• Hormone replacement therapy
• Thyroid dysfunction
• Stress and elevated cortisol levels
• Blue light exposure from screens

We offer a service to help manage this condition: Melasma Treatment .

• Melasma from pregnancy often fades after delivery
• Melasma from hormones may fade after stopping the medication
• Chronic melasma requires ongoing management
• Treatments can fade discoloration but may not eliminate it completely
• Condition commonly recurs with sun exposure
• Earlier treatment typically yields better results

1. What are the symptoms of Melasma?
2. When should you seek care for Melasma?
3. What causes Melasma?
4. How is Melasma treated?
5. Prognosis
6. FAQs
7. Sources

This article draws from 5 peer-reviewed sources.

• [1] Cleveland Clinic – Melasma Treatment, Causes & Prevention

• [2] AAD – Melasma Diagnosis and Treatment
• [3] AAD – Melasma Causes
• [4] AAD – Melasma Overview
• [5] AAD – Melasma Signs and Symptoms

Medically reviewed by Dr. Julia Tzu , MD, FAAD, FACMS · Last reviewed: 2026-08-31