Melasma

Melasma is a form of hyperpigmentation, which means certain areas of the skin produce more pigment than normal. The pigment responsible for skin color is called melanin. When melanocytes, the cells that make melanin, become overactive, patches of brown, gray-brown, or tan discoloration develop. These patches most commonly appear on sun-exposed areas of the face. The condition may worsen with sun exposure or hormonal changes like pregnancy.

The condition typically affects the cheeks, forehead, bridge of the nose, upper lip, and chin. In some cases, it can also appear along the jawline or on the neck. The discoloration usually develops gradually and appears in a symmetrical pattern, meaning both sides of the face are affected in a similar way. Unlike freckles or age spots, melasma tends to form larger, more defined patches rather than small, isolated spots.

Diagnosis begins with a thorough clinical evaluation. Dr. Richey examines the affected areas carefully to assess the pattern, color, and distribution of pigmentation. The symmetrical appearance and typical facial locations often make melasma recognizable on physical examination.

A detailed medical history is also important. Questions about pregnancy, hormone use, sun exposure habits, family history, and recent skincare products can help identify contributing factors. Reviewing medications is essential to rule out drug-induced pigmentation.

Although melasma is medically benign, it can be persistent and challenging to manage without professional guidance. Because it often fluctuates with sun exposure and hormonal changes, it requires a thoughtful and consistent approach.

Evaluation by a board-certified dermatologist ensures that the diagnosis is accurate and that contributing factors are identified. With careful assessment and individualized treatment planning, patients can take steps to manage pigmentation and protect their skin long term.