Dr. Perricone Discusses


Understanding the causes of Melasma and four ways to prevent and treat it

Melasma, sometimes referred to as the "mask of pregnancy", is characterized by blotchy, gray-brown spots or patches on the face, jawline and neck. Much like rosacea, Melasma typically appears on the planes of the face - nose, forehead, chin and above the upper lip, and it may also appear on other parts of the body that are frequently exposed to the sun, such as the décolleté and arms. Melasma is also similar to rosacea in that it is more common in women than in men. Hormones and sun damage are the most common triggers of Melasma.

Melasma is also similar to rosacea in that it is more common in women than in men.

While the actual causes of are not known, factors that increase one's likelihood of having Melasma include:

  • A blood relative who has Melasma
  • Excess sun exposure: Ultra violet light stimulates skin's melanocytes (part of the cell responsible for pigment production). Even a small amount of sun exposure can make Melasma return after treatment. This is perhaps why Melasma appears worse in the summer months and why it seems to come and go.
  • Darker skin tones: Darker skin has more melanocytes and therefore more pigment, which makes it more susceptible to developing Melasma
  • Common triggers include hormone fluctuations (pregnant women often experience chloasma or "the mask of pregnancy") and certain cosmetic products. Anything that irritates the skin can potentially worsen Melasma.


Melasma can be one of the slower skin conditions to resolve itself. It is best to start gently, particularly if you are using a prescribed medication or have sensitive skin. If the treatment is too aggressive, an increase in irregular pigmentation sometimes occurs. The best non-prescription option to correct the appearance of discoloration like Melasma is a multi-tiered approach:

  • Wear a broad-spectrum, non-chemical sunscreen daily with an SPF of at least 30.
  • Look for skincare products formulated with retinol, which supports healthy cell turnover (which naturally slows as we age).
  • Use a product with Vitamin C Ester to help brighten skin and encourage healthy collagen and elastin production, which can be slowed because of sun exposure as well as chronological aging.
  • Exfoliate the smart way, with a non-abrasive chemical peel.

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