Melasma And Uneven Color


In patients who experience melasma, the skin on the face is prone to brown spots and uneven pigmentation. Melasma is also known as the “mask of pregnancy.” The causes of melasma include –

  • Hormones including estrogen and fluctuations in hormone levels
  • Genetics
  • Sun Exposure
  • Inflammation or irritation
  • Heat (cooks seem to be more prone to developing melasma)

Melasma may worsen with birth control pills, exogenous estrogens, pregnancy, estrogen replacement therapy, and even plant estrogens in your diet.

Although estrogen has long been felt to be central to the cause of melasma, there are few studies to prove this. One can speculate, and since we do not have the research to back this up, the higher levels of estrogen and progesterone during pregnancy and oral contraceptives do indeed play a role in melasma.


Unfortunately, there is no known cure for melasma. It is a common disorder caused by increased pigmentation of the skin, usually on the exposed areas of the face. It is more common in women with darker skin tones, and women who are pregnant, on birth control pills, or taking hormone replacement.

Sun avoidance/sun protection and sunscreen use is probably the most important intervention you could do for melasma.

A broad-spectrum sunscreen with titanium dioxide, zinc oxide or avobenzone is suggested.

Treatments or interventions that can help reduce melasma include: hydroquinone (e.g. Eldoquin), a series of light chemical peels, azelaic acid, IPL, and the Dual Fraxel laser avialable in all CosmeSurge Centers. Special peels containing skin lightening agents other than hydroquinone such as kojic acid and vitamin C are available at all our Centers as well.


When considering melasma treatment, care and consideration must be used for patients with darker skin types, as hypo-pigmentation may occur, creating a separate skin problem. Dermatologist advise that you avoid exposure to sun, especially between 11 AM and 3 PM.