By Kevin C. Smith MD FACP FRCPC

Melasma is a common increase of pigmentation that occurs exclusively in sun-exposed areas, in particular on the face.


  • It is much more common in women between the ages of 20-40
  • Melasma is less common in older women, and is seldom seen in women taking estrogen replacement therapy
  • Melasma rarely affects men
  • Melasma is more of a problem in people who have relatively dark skin to begin with, and because melasma is made worse by sun exposure it tends to be more of a problem in the spring and summer
  • Melasma can be a particular problem for people in the service industry, where personal appearance can affect the amount of tips earned and can also affect gross sales by servers.

Melasma usually causes three different patterns of symmetrical pigmentation on the face, affecting most commonly the central face (cheeks, forehead, upper lip, nose, and chin); or less commonly the cheeks and nose, or the cheeks and jaw line. Melasma also can cause patches of pigmentation on the forearms, but this is rare.

There is no special diet, health food, vitamin, “magic lotion” which is useful for the treatment of melasma or other forms of facial pigmentation, and time and money should not be wasted on those things.

Melasma usually improves – sometimes to a great extent – in response to the faithful use a high-SPF, broad-spectrum sunscreen like Anthelios® SPF60 every morning and Lustra® at night. Sun protection needs to be continued long-term in order to reduce the risk of relapse of melasma. Severe cases can be treated with a prescription for the mixture of 4 parts Anthelios® SPF60 sunscreen with 1 part Tazorac® 0.05% cream every morning, and Lustra® cream at night.

In some cases, improvement in melasma and other forms of facial pigmentation can be speeded up with intense pulsed light (IPL) treatments, in particular by the Cutera 600 IPL which is optimized for the reduction in unwanted facial pigment. Sun avoidance and using a sunscreen every day are essential steps to preventing melasma.

Click on sunscreens to learn more, or for general skin care, visit Skin Care

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