Melasma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Melasma?
A dermatologist, a doctor who treats skin conditions, usually treats melasma. A primary care doctor can often spot it and start a plan. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is melasma?
Melasma is a skin condition that causes patches of dark skin on areas of the face exposed to the sun. It is common. It most often appears in young women with brownish skin tone, but it can affect anyone. Some people call it chloasma or the mask of pregnancy.
Melasma does not harm your body. Still, it can take a toll on your emotions. Some people feel self-conscious about how it looks.
Symptoms
The only symptom of melasma is a change in skin color. The patches are usually brown. They often show up on these parts of the face:
- Cheeks
- Forehead
- Nose
- Upper lip or chin
Dark patches are often the same on both sides of the face. Sometimes melasma shows up on the jawline, neck, or arms. The patches can look like freckles. On darker skin tones, melasma can look bluish gray. It tends to become more noticeable when you spend time in the sun.
Causes and who gets it
Melasma is often linked to the female hormones estrogen and progesterone. It is common in pregnant women, women who take birth control pills, and women who take hormone replacement therapy during menopause. Sunlight is another trigger, and stress can also play a part. Being in the sun makes melasma more likely to develop. It is more common in tropical climates.
Melasma mainly affects women, but some men develop it too.
How doctors diagnose it
A health care provider looks at your skin to diagnose melasma. A dermatologist can often diagnose it by looking closely at your face and neck. The doctor may use a Wood's lamp, a device that uses ultraviolet light, or a dermatoscope. These tools show how deep the dark color goes in the skin.
Sometimes melasma looks like another skin condition. To rule this out, the doctor may do a skin biopsy. This means removing a small bit of skin for testing.
Treatment
There is no one best treatment for melasma. Often the most effective plan combines sun protection with medicines you apply to your skin, and sometimes a procedure. Treatment is not considered medically necessary, so most insurers will not cover the cost.
Sun protection matters most. Sunlight makes the skin produce more pigment, which can darken melasma and cause new patches. Dermatologists suggest a wide-brimmed hat, shade, and a broad-spectrum sunscreen with SPF 30 or higher. Sunscreens with zinc oxide, titanium dioxide, or iron oxide are often recommended. Use sunscreen year-round and avoid tanning beds.
A dermatologist may prescribe skin creams such as hydroquinone, a tretinoin and mild steroid mix, or a triple combination cream. Gentler options include azelaic acid, kojic acid, or vitamin C. Hydroquinone is no longer sold without a prescription. If hormone medicines may be causing melasma, ask your doctor whether a change is right for you. Do not stop a prescribed medicine on your own.
If melasma is stubborn, a dermatologist may add a chemical peel, microneedling, a laser or light treatment, or platelet-rich plasma. Only a board-certified dermatologist should do these procedures. For very hard cases, a doctor may talk about tranexamic acid. Tell your doctor if you have ever had a blood clot. Camouflage makeup can hide melasma while treatment works.
When to see a doctor
Contact your provider if you have darkening of your face that does not go away. A dermatologist can tell you whether you have melasma or another condition. Ask about the cost of treatment before you start.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can look at your skin, review any hormone medicines you take, and refer you to a dermatologist for treatment or procedures.
Common questions
Does melasma go away on its own?
It can. Melasma may go away on its own, which usually happens when a trigger such as pregnancy or a medication causes it. It can also last for years, or even a lifetime.
Is melasma harmful?
No. Melasma does not harm your body, but it can affect how you feel about your looks.
Can the sun make melasma worse?
Yes. Sunlight makes the skin produce more pigment, which can darken melasma. It can also come back after sun exposure.
How long does melasma treatment take to work?
Treatment usually takes 3 to 12 months to show results. It may take longer if you have had melasma for a long time.
Can men get melasma?
Yes. Melasma mainly affects women, but some men get it too.
Sources
- MedlinePlus - Melasma
- American Academy of Dermatology - Melasma: Diagnosis and treatment
- American Academy of Dermatology - Melasma: Signs and symptoms
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
