Melasma (aka chloasma, mask of pregnancy) is a very common condition of adult women that appears as dark spots on the face. It commonly affects the upper lip, cheeks and forehead. Some women complain of the "mustache" appearance it gives them. Very rarely, a man may develop melasma.
Melasma seems to result from two main things: female hormones and the sun. Women with darker skin (e.g., Hispanics, Filipinos) are most commonly affected. Pregnancy and birth control pills may trigger melasma.
Yes. Melasma protects the skin from the sun and future skin cancer of the face. So if you are going to try to eliminate melasma, you must be diligent about wearing sunscreen every day.
Avoiding sun is critical. Avoid prolonged times in the sun. Wear hats and seek the shade. Stay indoors particularly when the sun is the strongest, i.e., from 9 AM to 3 PM. Wear sunscreen.
Yes! The daily use of a tinted, physical block sunscreen is critical. Believe it or not, visible light--not just ultraviolet light--causes/aggravates melasma. Thus, it is very important to apply a tinted, physical block sunscreen that contains iron oxide immediately upon wakening and several times a day, especially if you work out or sweat. Search on the internet for "broad spectrum tinted sunscreen containing iron oxide". Examples include:
Various bleaching creams can be compounded by a specialty pharmacy. Speak with your doctor about which is right for you.
Give any topical treatment at least three to six months to have its effect Bleaching by about half over six months is average. Remember that melasma is very difficult to completely eradicate. If you are not satisfied with the amount of lightening, you may want to consider the risks and benefits of tranexamic acid, chemical peels, or laser.