Melasma is a common skin disorder characterized by dark patches (hyperpigmentation), primarily on the face. The cause of the disorder is unknown, but seems to be related to hormonal change. It affects women more than men. Melasma is usually associated with pregnancy, oral contraceptives, or anti-seizure medication (e.g. phenytoin [Dilantin]). It is so common in pregnancy that it is referred to as “the mask of pregnancy.” Melasma has no specific symptoms but causes alarm due to its appearance.
For some women, melasma resolves without intervention. For those requiring treatment, available therapies include topical treatment with hydroquinone 3-percent or 4-percent, glycolic acid 10-percent peel, azelaic acid 20-percent cream, and retinoids (e.g. tretinoin 0.05-percent or 0.1-percent cream, adapalene [Differin] 0.1-percent or 0.3-percent gel). Keep in mind, not all cases of melasma clear with treatment. Prevention of melasma may be aided by wearing sunscreen (at least SPF 30) and wide-brimmed hats.