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Melasma diagnosis, treatment and medications

Connect with an Online Dermatologist today! Medications delivered to your preferred pharmacy 

Melasma Treatment FAQ

Can a Dermatologist treat Acne at DermCafé?

Absolutely! Dermatologists can diagnose most patients simply by looking at their skin.

What is melasma

Melasma is a common skin problem. It causes brown to gray-brown patches, usually on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It also can appear on other parts of the body that get lots of sun, such as the forearms and neck.

What causes melasma?

What causes melasma is not yet clear. It likely occurs when the color-making cells in the skin (melanocytes) produce too much color. People with skin of color are more prone to melasma because they have more active melanocytes than people with light skin. 

Common melasma triggers (what starts it) include: 

  • Sun exposure: Ultraviolet (UV) light from the sun stimulates the melanocytes. In fact, just a small amount of sun exposure can make melasma return after fading. Sun exposure is why melasma often is worse in summer. It also is the main reason why many people with melasma get it again and again. 

  • A change in hormones: Pregnant women often get melasma. When melasma appears in pregnant women, it is called chloasma, or the mask of pregnancy. Birth control pills and hormone replacement medicine also can trigger melasma. 

  • Skin care products: If a product irritates your skin, melasma can worsen.

Who gets melasma?

Melasma appears on women’s skin much more often than men’s skin. Just 10% of people who get melasma are men. It is so common during pregnancy that melasma is sometimes called "the mask of pregnancy." Hormones seem to trigger melasma.

People with darker skin, such as those of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, or Mediterranean descent are more likely to get melasma. People who have a blood relative who had melasma also are much more likely to get melasma.

How is it treated?

Melasma can fade on its own. This usually happens when a trigger, such as a pregnancy or birth control pills, causes the melasma. When a woman delivers her baby or stops taking the birth control pills, melasma can fade. 

However, some people have melasma for years, or even a lifetime. If the melasma does not go away or a woman wants to keep taking birth control pills, melasma treatments are available. These include: 

  • Hydroquinone: This medicine is a common first treatment for melasma. It is applied to the skin and works by lightening the skin. 

  • Tretinoin and corticosteroids: To enhance skin lightening, your dermatologist may prescribe a second medicine. This medicine may be tretinoin or a corticosteroid. Sometimes a medicine contains three medicines (hydroquinone, tretinoin, and a corticosteroid) in one cream. 

  • Other topical (applied to the skin) medicines: Your dermatologist may prescribe azelaic acid or kojic acid to help lighten melasma.

What is DermCafé?

Connect with a DermCafé Dermatologist today! 

We’re a Digital Dermatology Centre that aims to provide all Canadians with equitable, accessible, convenient and modern dermatology care.

Simply submit your symptom info and skin photos online and connect with an online dermatologist at your convenience.

Visit our How This Work page to learn more. 

Step 1

Submit your Symptom Info and Photos online

Step 2

Book your Online Appointment

Step 4

Access Your Online Results Anytime

Choose your preferred Pharmacy for prescription delivery

Download DermCafé Info Sheets, bloodwork forms and Sick Notes, and book follow-up appointments when needed

Step 3

Audio/Video Visit with Your Dermatologist

OHIP/MSP-covered visits require a Referral by another Physician/Nurse Practitioner. Or, book an appointment with our Family Doctor first.

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