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Melasma, or chloasma, is a skin condition common in women that is characterized by hyperpigmentation, or darkened patches of facial skin, including the forehead, cheeks, nose or upper lip.


Melasma Causes


Fluctuations in estrogen and progesterone hormone levels in females that may occur in response to hormonal birth control methods, hormone replacement therapy associated with menopause or pregnancy are often to blame for causing melasma.  This is why melasma is often called the “mask of pregnancy.”

The following birth control methods can cause melasma:

     The pill (any oral contraceptive/OCP or birth control pills)

     The shot (DMPA)

     The patch (Ortho-Evra)

     The implant (Nexplanon)

     The ring (Nuvaring)

     The IUD (Hormonal IUDs (Mirena, Kyleena, Liletta, and Skyla) contain hormones.  Paragard is a copper IUD and does NOT contain hormones)


Melasma Symptoms


Skin discoloration from melasma is different from other forms of hyperpigmentation; it is less predictable and more difficult to treat. Otherwise, melasma may be easily mistaken for sun damage, freckles or post-inflammatory hyperpigmentation, which may occur temporarily after some laser treatments, such as skin resurfacing or photofacial.


Melasma Treatment


The safest and most effective treatment options for melasma include:


  • Skin lightening creams include the following options:

    • azelic acid

    • retinoids (tretinoin or Retin-A, also one of the ingredients in TriLuma and Obagi products)

    • hydroquinone

    • kojic acid

    • tranexamic acid 

  • Chemical Peels

  • Laser
    • Jester(Salicylic acid, Lactic acid and Resorcinol)

  • Trichloroacetic (TCA)​


For women who develop melasma during pregnancy, the safety of the above treatments has not been fully evaluated.


When changes in the normal hormone levels resolve, melasma may also resolve on its own, but this is not always the case.  


Sun exposure worsens melasma, so wearing a hat and using broad spectrum sunscreen with a powerful sun protection factor each day is important for women suffering from melasma.


Call us to find out more about melasma.

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