How to Treat Melasma, According to Dermatologists

Also known as: How to get rid of those weird spots on your face.

melasma treatment
(Image credit: Edward Berthelot)

Recently, a friend mentioned to me that her skin had suddenly developed a weird, blotchy, brownish rash when she was on vacation. “It looked like a bunch of acne scars above my lip and on my forehead,” she said. "It was like a dark shadow that wouldn't go away." When she finally went to the dermatologist after three weeks of my daily, annoyingly pushy reminders, she discovered that the splotches were not, in fact, scars, but melasma—a skin condition that can happen to anyone (cue scary music). Just kidding: Melasma is not, in fact, the kiss of death—it's just annoying to deal with.

Skin, Face, Nose, Cheek, Close-up, Chin, Neck, Flesh, Jaw, Muscle,

(Image credit: Standard Images)

What is melasma?

Skin Laundry medical director Dr. Roberta Del Campo explains: "Melasma is a common condition that appears as irregular patches of tan, brown or brown-gray pigmentation, usually on the face."

It occurs when skin’s melanin-producing cells (melanocytes) are hyperactive, she says. The reason most derms approach melasma with a weary eye is that it's complex, solely because it can be caused by a variety of factors, including “genetic tendency, increased estrogen, and skin type,” says skin wizard, Annie Chiu, M.D., dermatologist at The Derm Institute.

What causes melasma?

Basically, anyone with skin is at risk for developing melasma (you should of course, always talk to your derm for an official diagnosis), but Dr. Chiu and Dr. Del Campo says you're especially susceptible to melasma if:

  • You're pregnant. Melasma is so common in pregnant women, thanks to hormonal fluctuations, that it's earned the name "pregnancy mask."
  • You have naturally darker skin: Fitzpatrick skin types IV and V (skin tones on the darker side) are predisposed to melasma.
  • You love hanging outdoors. UV rays from sun exposure stimulate skin cells to create excess pigment.
  • You stare at a computer all day. The visible light from your computer, tablet, and cell phone can all trigger melasma.

Face, Cheek, Lip, Nose, Skin, Chin, Forehead, Head, Close-up, Eyebrow,

(Image credit: Archives)

See? That's pretty much the majority of the population, which makes preventing melasma difficult, simply because it can be aloof—it comes and goes as it pleases.

With that said, “the most common trigger for melasma is UV light from sun exposure,” says Dr. Del Campo, so keep that in mind before you think to skip your daily application of an SPF that's at least 30.

What's the best treatment for melasma?

Melasma is treatable, but it requires a good amount of dedication to treating your skin. “In office, we use peels and very specific low-level lasers to break up the pigment," says Dr. Chiu.

Dr. Del Campo also recommends laser treatments, noting the advancements of the Skin Laundry system: “This treatment not only improves discoloration but also helps decrease recurrence.” (Editor's note: Having undergone the treatment myself, I was scared that it would cause my skin to get worse—but after two sessions I noticed a difference in my hyperpigmentation caused by melasma.)

For the at-home skincare routine, Dr. Chiu says, "We have patients treat their melasma at home with a mix of prescription-strength hydroquinone, kojic acid, retinol, and vitamin C products, as well as be meticulous about applying UVA- and UVB-protecting sunscreen.”

4 Best At-Home Melasma Treatments

What creams should I use to treat melasma?

While it’s vital to see a derm to get long-lasting treatment, you can still keep the pigmentation at bay with the best of the best spot-fading products and sunscreens. We can not stress enough. Please. Wear. Sunscreen. Dr. Del Campo recommends a zinc oxide or titanium dioxide sunscreen over a chemical SPF containing oxybenzone and homosalate.

Make sure you pay attention to the active ingredients in your products, with a focus on the ones Dr. Chiu mentioned. If your product includes oxybenzone, homosalate, or fragrance skip it, Dr. Del Campo says. "Choose gentle skincare products that don’t sting or burn." Now, let’s avoid making that melasma worse and put that dedication into a routine because your skin deserves it.