Melasma is a harmless but incredibly frustrating skin condition. It can negatively affect your quality of life and self-esteem. Understanding the condition and treatment for melasma can empower you to seek help. Read on to learn more. 

What is Melasma?

Melasma is a skin condition that causes brown or blue-gray patches or freckle-like spots. It occurs in the epidermis, the outer layer of your skin. The discoloration caused by melasma is most common on the nose bridge, forehead, cheeks, upper lip, and chin, but it can also appear on your forearms, neck, and shoulders.


This distressing skin condition is prevalent. It affects more than five million people in the United States. Depending on the population, it may affect between 1.5 and 33 percent of all people. 

Who Gets Melasma? 

Melasma is much more common in women than in men. If you’re a woman between 20 and 40, you have the highest risk of developing melasma. It is also more frequent in people with darker skin tones, such as those of Latin, Asian, Black, or Native American heritage. 

What Causes Melasma? 

Experts believe that elevated levels of the hormones estrogen and progesterone play a role in the development of melasma. It is common during pregnancy due to a steep rise in those hormones, which is why it is called the “mask of pregnancy.” 

Other causes of melasma include: 

  • Exposure to light causes melanocytes to produce more melanin, darkening your skin. Tanning beds and sunlamps have stronger UV rays than sunlight, which makes them even more likely to cause skin discoloration. 
  • Certain medications, such as birth control pills, retinoids, and some antibiotics or blood pressure medications. 
  • Although controversial, some experts believe that the extra cortisol your body manufactures when under stress can trigger melasma.
  • Thyroid disease can increase your risk of developing melasma.
  • Genetics play a role, as about 33 to 50 percent of people with melasma report they have a family member who has it.

One of the most confounding aspects of melasma is that it’s difficult to treat. Even after treatment, your skin can relapse and return to its patchy condition. That is because you may still have high levels of melanin in your skin, making it more likely to react to sun exposure. 

If your melasma is from pregnancy or medication, it may go away after you deliver your baby or stop taking it. In other cases, it can last throughout your life. 

Treatment for Melasma 

If you suffer from melasma, there are many treatment options, including topical medications, laser therapy, and chemical peels. Here’s what you need to know about each.  

Topical and Oral Medications 

  • Hydroquinone, a common topical medication for melasma, damages the melanin-producing cells to reduce hyperpigmentation.
  • Tretinoin and mild corticosteroids increase skin turnover and inflammation to even out skin tone.
  • Triple combination cream includes hydroquinone, tretinoin, and a corticosteroid.
  • Additional topical treatments such as azelaic acid, kojic acid, vitamin C, and alpha hydroxy acid also help accelerate skin turnover. 
  • Oral medications include methimazole, which also comes in a cream, and tranexamic acid, which also comes in a cream or injectable. 

Chemical Peels

Chemical peels are another treatment for melasma. During this procedure, a doctor or aesthetician applies a chemical to your skin, which causes the top layer to peel off, resulting in smoother, more even-toned skin.  

Laser Treatments 

Laser is a safe option that can be very effective if you haven’t responded to other melasma treatments. 

PicoSure, a breakthrough laser treatment, turns energy into pressure rather than heat, shattering pigment without burning or damaging surrounding tissue. Fractional laser resurfacing, another option, makes tiny holes to stimulate new cell growth. PicoSure is considered gentler and requires less downtime. 

Other options include intense pulsed light laser, which uses multispectral lights in different wavelengths to target darkened skin, and Q-Switch, which delivers energy to break up melanin and remove it from your body.  

How to Keep Your Melasma from Getting Worse

If you have melasma, you can take simple steps to prevent it from getting worse. Most importantly, wear sunscreen with at least 30 SPF every day. Never use tanning beds or sunlamps, and choose gentle, fragrance-free skin products.

Ink-B-Gone PicoWay Treatment for Melasma

At Ink-B-Gone, Denver’s premier tattoo removal specialist, we use PicoWay RESOLVE laser treatment to remove tattoos and treat melasma, sun and age spots, acne scars, and wrinkles. This safe and highly effective treatment uses a picosecond laser beam with high power and ultra-short pulses for a quick, safe procedure with NO downtime! Want to learn more? Follow us on X and Instagram.