Melasma is a common patchy, brown facial discoloration occurring primarily in women.
- Genetics: Women with brown pigmented skin, ie, Latinos and Asians.
- Hormonal influences: Pregnancy and the birth control pill (BCP).
- Sun exposure.
- Strict sun avoidance with use of a broad spectrum sunscreen with UVA and UVB protection and SPF 50.
- Consider discontinuing the birth control pill (when involved).
- Use of prescription bleaching agents. Those containing Hydroquinone with or without Tretinoin and a mild steroid are most effective.
- Non-prescription bleaching agents containing kojic acid and vitamin C have been shown to be effective.
- Superficial chemical peels.