Melasma is a common skin disorder. Loosely translated, the word means “black spot.” If you have melasma you’re probably experiencing light brown, dark brown and/or blue-gray patches on your skin. They can appear as flat patches or freckle-like spots. Commonly affected areas include your face, including the cheeks, upper lip and forehead, as well as the forearms. Melasma is sometimes called the “mask of pregnancy” because it frequently affects pregnant women. Melasma typically darkens and lightens over time, often getting worse in the summer and better in the winter.
Another, less common name for melasma, is chloasma. Although this disorder is completely harmless, it understandably makes some people feel self-conscious.
Melasma appears most commonly on your cheeks, nose, chin, above the upper lip and the forehead. It sometimes affects your arms, neck and back. In fact, melasma can affect any part of your skin that is exposed to sunlight. That’s why most people with melasma notice that their symptoms worsen during the summer months.
Melasma is a very common skin disorder, especially among pregnant women. 15% to 50% of pregnant women get it. Between 1.5% and 33% of the population may get melasma and it happens more often during a woman’s reproductive years, and rarely happens during puberty. It usually starts between 20 and 40 years of age.
Fairer-skinned people are less likely to be affected by melasma than those with darker brown skin or those who tan well. Women are more likely to get melasma than men: about 10% of those who get melasma are men, 90% women. Pregnant women get melasma more often than anyone else. You’re also at risk if you take oral contraceptives and hormones.
Pregnant women have increased levels of the hormones estrogen and progesterone. These hormones are thought to contribute to your melasma. The darker color usually fades after pregnancy.
There are three types of melasma and they have to do with the depth of the pigment. A Wood’s lamp that emits black light may be used to determine the depth of the pigment. The three types are:
1. Epidermal: Epidermal melasma has a dark brown color, a well-defined border, appears obvious under black light and sometimes responds well to treatment.
2. Dermal: Dermal melasma has a light brown or bluish color, a blurry border, appears no differently under black light and doesn’t respond well to treatment.
3. Mixed melasma: Mixed melasma, which is the most common of the three, has both bluish and brown patches, shows a mixed pattern under black light and shows some response to treatment.
Melasma is not cancerous, a sign of cancer, or a skin condition that “turns into” cancer. However, there are skin cancers that may mimic melasma, so seeing your dermatologist is often recommended to confirm the correct diagnosis.
Melasma is a typically chronic disorder. This means that it’s long-lasting (three months or more). Some people have melasma for years or their entire lives. Other people may have melasma for just a short time, such as during pregnancy.
Melasma is harmless. It’s not painful, itchy, or uncomfortable in any way.
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