Melasma & Pigmentation

What Is Melasma & Pigmentation?

Melasma is a common skin disorder characterized by brown or blue-grey patches or freckle-like spots. It’s often referred to as the “mask of pregnancy” because it frequently affects pregnant women. This type of hyperpigmentation (patches of the skin that are darker than the surrounding skin) manifests its symptoms as:

  • Patchy discoloration: Light brown, dark brown, and or blue-gray patches appear on the skin.
  • Affected areas: Commonly seen on the face (cheeks, upper lip, or forehead), forearms, and sun-affected skin surfaces.
  • Seasonal condition: Melasma typically darkens in the summer and lightens in the winter.

Melasma does not itch, burn, or have overlying scaling, pimples, or pustules. Melasma is a specific type of hyperpigmentation, an excess of pigment in the skin. The variations in skin pigmentation are influenced by genetics, hormones, and evolutionary adaptations to allow survival in different environments.

What Are the Causes of Melasma and Pigmentation?

Melasma occurs due to the overproduction of melanin by melanocytes (pigment-producing cells). Here are their usual triggers:


Hormonal changes during pregnancy may contribute, especially the increased level of estrogen.

Sun exposure

UV rays worsen melasma production. Prolonged exposure to sunlight stimulates melanocytes, leading to increased melanin, freckles, and sun spots in the affected sites.

Estrogen and progesterone sensitivity

Hormonal medications from oral contraceptives to hormonal replacement therapy can cause hormonal fluctuations that contribute to melasma. For instance, some women experience the darkening of the areolas during pregnancy.

Genetic factors

Family history may also increase the risk.

Stress and thyroid disease

These are also associated with melasma. If you suspect a thyroid condition, consult with a dermatologist who can refer you to an endocrinologist for comprehensive management.


Melasma is more common in women in 90% of cases.

Inflammation and skin trauma

Skin acne or even minor trauma, like scratching, can worsen existing melasma patches. After injuries like cuts and burns heal, localized darkening of the skin can also occur.