Melasma

What is melasma?

Melasma is a dermatological condition that causes patches of your skin to become darker. It’s not harmful or contagious, won’t lead to any further complications, and causes no physical symptoms other than those visible on the skin — it only affects your appearance. But that doesn’t mean it’s not worth treating. The change in appearance that it does cause can have a significant effect on your self-confidence, or mental health more broadly.

It’s thought to be triggered by exposure to UV light, which tends to make it more noticeable in the summer months, with symptoms typically fading over winter. Melasma is also particularly common in pregnancy, which is why it’s sometimes also called: ‘pregnancy mask’.

Who gets melasma?

Anyone can get melasma, but research shows that it’s far more common in women than it is in men, with the American Academy of Dermatology claiming that around 90% of the people who get melasma are female.^[1] This is, in part, due to the increased likelihood of getting it during pregnancy. It’s thought that somewhere between 15% and 50% ^[2] of pregnant women will get it. Usually the condition goes away once the baby has been delivered, but may come back with any subsequent pregnancies.

Melasma has also been shown to be more common in people of colour, or in those who tan quite easily, as well as people with a family history of it (though there’s no evidence that it’s hereditary). It also tends to appear for the first time in people between the ages of 20 and 40.

How common is melasma?

Melasma is a fairly common condition, but exact information on just how common is a little difficult to come by. Estimates suggest that 1.5% to 33% of people have it, depending on the population. So, depending on where you live, it may affect as little as one-or-two out of a hundred people around you, or as many as one in every three.^[2]

What causes melasma?

The exact cause of melasma remains unknown, however experts think it might be caused by pigment-producing cells in your skin (called melanocytes) making too much melanin (which is the pigment that causes darker skin). When this happens, it can cause the patches of darker skin you get with melasma.

Other things that can cause (or lead to) melasma are:

• Pregnancy, thought to be due to changing hormone levels;
• Hormonal treatments, such as contraception or HRT, again, due to hormone changes;
• UV exposure, either from the sun or tanning beds;
• Other conditions, such as thyroid problems (though this is rare); or:
• Other medications, such as antiepileptics (though this, too, is rare).

What are the symptoms of melasma?

Melasma is characterised by patches of darker skin, usually on the face. It can also affect other areas of the body that are routinely exposed to sunlight, such as your neck and forearms. These patches of darker skin are not raised in any way, and don’t cause any altered sensation. They’re not painful, itchy or sensitive.

Can melasma lead to other problems?

No, melasma is benign (meaning it doesn’t cause any other health issues or complications). It can, however, affect quality of life. This may happen if you feel particularly self-conscious about your changing appearance. Because of this, it may lead to mental health conditions such as anxiety.