Brown Patchy Skin May be Melasma

Community Member

One of our more popular questions we receive here on MySkinCareConnection   is about brown spots on the face and how to get rid of them. In response we got the expert opinion of Dr. Lawrence Green, a practicing dermatologist, to give you some ideas of how to eliminate brown spots or hyperpigmentation from your skin. As Doctor Green has wisely pointed out, the treatment for getting rid of brown spots greatly depends on the cause. One cause for dark patches of skin is a skin condition called melasma.

What is melasma?

Melasma is considered to be a benign skin condition which can cause dark patches and freckle like spots to appear on the face. Less frequently it can spread to the sides of the neck. Melasma is usually a temporary skin disorder and may disappear on its own within a few months or as long as a few years.

Who gets melasma?

  • Melasma is sometimes called the mask of pregnancy because melasma is a common skin disorder among pregnant women. In this case, the pigmentation usually resolves within a few months following delivery.

  • Melasma affects far more women than men. Only ten percent of individuals with melasma are men.

  • People with dark skin tones are more likely to have melasma.

  • In addition to pregnant women, melasma also affects women who are taking birth control pills or using hormone replacement therapy (HRT) during menopause.

  • Individuals who are exposed to the sun are more at risk for developing melasma. People who live in tropical climates are much more likely to have this skin condition.

What are some of the triggers for developing melasma?

Some of the known triggers for melasma include: Sun exposure, scented soaps or toiletries, genetic susceptibility, pregnancy, birth control pills, hormone replacement therapy, some antiseizure medications, and also medications which increase one's sensitivity to ultraviolet light.

What does melasma look like?

Melasma will look different for each individual but generally there are patches of brown mottled pigmentation covering certain areas of the face including the forehead, cheeks, or upper lips. The New Zealand Dermatological Society has images of what melasma can look like for different skin types.

How is melasma treated?

Your doctor or dermatologist will diagnose melasma and then decide if treatment is necessary. In many cases melasma will fade on its own especially for pregnant women. If your melasma is a cosmetic concern and is not going away on its own, there are treatments available to minimize the brown patches. Your treatment options may include:

  • Eliminating any known triggers such as discontinuing birth control pills or hormonal replacement therapy (See your doctor before making such a decision). If cosmetics, soaps, or other toiletries are a known trigger, changing products can help.

  • Regular use of sunscreen is a must as sun exposure can not only trigger melasma but can cause it to reappear after fading.

  • Bleaching creams such as hydroquinone, azelaic acid, or Kojic acid have been used by some individuals with melasma with great success.

  • Chemical peels are another method of fading melasma such as using salicylic acid or topical retinoids such as tretinoin.

  • Laser resurfacing of the skin is used by some to get rid of their brown skin patches caused by melasma but results can greatly vary.

It is important to seek the guidance of a dermatologist for treating your melasma. Your doctor will be able to advise you on the best treatment for your melasma and skin type.

For more information about how to get rid of brown spots please refer to the following Health Central articles:

Melasma Resources