Melasma or Hyperpigmentation

Melasma is a common skin condition in which patches of skin on the face darken. Typically, the affected areas are the cheeks, bridge of the nose, forehead or upper lip. The dark patches are often symmetrical. Melasma can occur in anyone, but is much more frequently found among women, especially women who are pregnant when it is called chloasma, and is sometimes referred to as the "pregnancy mask." Although not a painful or dangerous problem, melasma can be very distressing emotionally because of its alteration of the appearance. Melasma is not always a permanent condition. It may disappear in a woman several months after she gives birth, but may reoccur after unprotected exposure to the sun.

Risk Factors for Melasma

While the precise cause of melasma is unknown, certain individuals have a genetic predisposition to developing this condition and it more frequently occurs in people with brown skin. There is also a clear correlation between female hormones and melasma, since not only are pregnant women more susceptible, but so are women on birth control or hormone replacement therapy. Sun exposure makes the development of melasma more likely, so women in tropical climates are more prone to the condition.

Diagnosis of Melasma

Melasma is usually diagnosed through a simple physical examination of the skin. A Wood's lamp, which uses ultraviolet light, is used to highlight skin discolorations and direct the course of treatment.

Treatment for Melasma

Sometimes patients may achieve symptom relief if they stop taking estrogen and progesterone, the hormones linked to the disorder. Other treatments for melasma may include:

  • Topical skin-bleaching agents
  • Chemical peels
  • Topical corticosteroids
  • Laser treatment
  • Intense pulsed light (IPL) therapy
  • Microdermabrasion or dermabrasion

Patients with melasma should apply strong sunscreen or sunblock outdoors since sun exposure will worsen the condition.

Treatment for Facial Discoloration

Facial discoloration is caused when the cells that make melanin, which are responsible for the skin's pigmentation, become damaged or unhealthy. Skin that has too much melanin is referred to as being hyperpigmented; skin that has too little melanin is referred to as being hypopigmented.

Types of Treatments

Facial hyperpigmentation is often caused by exposure to ultraviolet light; taking the hormones estrogen and progesterone; and the aging process. There are a number of treatments available.


Skin-bleaching liquids, creams, lotions and gels effectively treat brown facial discolorations. Most bleaching lotions use hydroquinone, which, when applied topically, lightens dark spots by reducing the amount of melanin present.

Chemical Peel

Damage to the top and middle layers of the skin can be treated with a chemical peel, which involves applying a small amount of an acid solution to the discolored skin. A small wound is created, and, when it heals, new unblemished skin has replaced it.


During microdermabrasion, a handheld device is used to sand away the outer layer of skin, removing discoloration and improving the look of the skin in general. The device transmits tiny crystal particles across the discolored skin to exfoliate the surface layer, and a vacuum tool removes the exfoliated skin.

Laser Treatment

Using a wandlike handpiece, laser treatment focuses an intense beam of bright light on the discoloration. The laser beam removes the discolored skin by vaporizing it. There are a number of different laser treatments, and which one is best depends upon the amount and type of skin damage being treated. Types of laser treatment include:

  • Nonablative laser rejuvenation
  • Intense pulsed light (IPL)
  • Photodynamic therapy (PDT)
  • Fractional laser rejuvenation
  • Ablative laser resurfacing


Treatment using liquid nitrogen is referred to as cryotherapy, and it can be used to successfully treat facial discolorations. Liquid nitrogen is sprayed on the discolored skin, freezing it and turning it white. A small blister will form and, when it heals, usually about 1 or 2 weeks later, the discoloration will be gone.

In general, the best ways to avoid facial discoloration are to use sunblock on a regular basis, and avoid sun exposure as much as possible.

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