Melasma and dark spots

Melasma causes brown or gray-brown patches, usually on the cheeks, forehead, upper lip and chin. It is more common in women and in people with medium to dark skin tones, and it is often triggered by sun, heat and hormones, including pregnancy and birth control.

Melasma can be stubborn and tends to come back, but it can be improved with a steady plan. We also treat other dark spots, such as sun spots and marks left after acne or other skin injuries.

Signs and symptoms

• Brown or gray-brown patches on both sides of the face
• Patches that darken in summer or after sun exposure
• Darkening during pregnancy or while on hormones

How we treat it

• Daily sun protection: broad-spectrum SPF 30 or higher sunscreen, plus a tint containing iron oxides to help protect against visible light, along with shade and protective clothing.
• Prescription creams: such as hydroquinone, tretinoin and combination creams
• Chemical peels or selected laser treatments may be considered for some patients. These can worsen pigmentation, so careful assessment is essential.
• Medical-grade skincare to maintain results

Where it is offered

Melasma Q&A

Related care

• Post-inflammatory hyperpigmentation
• Sun damage and sun sensitivity
• Chemical peels
• Skin of color