Information about the skin condition melasma, as well as guidance about what support is available from Changing Faces and other organisations.
Melasma, also known as “chloasma” , is a common skin condition affecting adults. It causes pale to dark brown or greyish pigmentation (colouring) on the affected areas. Affected areas are flat not raised. It may be more noticeable during the summer and improve over the winter months. It is not cancerous.
Onset typically occurs between the ages of 20 and 40. Melasma is sometimes called “pregnancy mask” because it is more common in women who are pregnant. Research suggests that up to half of women may experience melasma during pregnancy. It is more common in people of colour and those who tan quickly.
If you have melasma, you may feel self-conscious about your appearance – support is available to help you with the challenges you may face. On this page, we explore what melasma is and look at what support is available to help you overcome the challenges of living with the condition.
Melasma causes skin to darken, usually in symmetrical patches. It typically affects the following body parts:
It may also affect the neck and, occasionally, the forearms.
Melasma does not cause bumps or raised skin, or pain, itchiness or soreness.
Although the root cause of melasma is unknown, symptoms are thought to be caused by melanocytes (pigment-producing cells in the skin) making too much of the skin pigment melanin.
Symptoms may be triggered by:
Melasma often seems to run in families, with 40% reporting that family-members are affected.
There are three types of melasma or chloasma:
Epidermal melasma is characterised by a well-defined border and dark brown patches arranged in a scattered pattern. Epidermal melasma is accentuated when viewed under a Wood’s lamp (a torch which uses ultraviolet light to reveal skin conditions) and it responds well to treatment.
Dermal melasma has an ill-defined border and patches appear pale brown to blue-grey. Their appearance is not enhanced by a Wood’s lamp and the condition does not respond well to treatment.
In mixed melasma, patches may be dark brown to blue-grey. Symptoms may or may not be more visible under a Wood’s lamp. Treatment is sometimes successful.
Melasma should be easily diagnosed by your GP due to its distinctive pigmentation and distribution of the patches. In some cases, a biopsy may be taken.
There is currently no cure for melasma, but there are various ways to treat and manage symptoms.
Melasma which occurs during pregnancy may clear up without treatment after childbirth.
It is important to protect any skin affected by melasma from exposure to sunlight. You should use a sun cream with SPF 30 or higher and a four- or five-star UVA rating. You should also avoid using a sun bed.
Avoiding the sun can lead to a vitamin D deficiency. Taking a supplement can help keep your vitamin D levels up. You can get vitamin D tablets from most pharmacies and large supermarkets.
Certain chemicals can stop or limit melanocytes from making pigments. These are available as creams which can be prescribed by a medical professional.
A number of other treatments are used in some cases but they are not always available on the NHS. These include:
You may find that the effects of melasma on your appearance impact your self-esteem and confidence levels. You may be more aware of others staring at you, and it can be particularly challenging if people make comments or ask questions about your appearance.
If you’re struggling with the impacts of melasma on your life, help is available.
At Changing Faces, we offer counselling and wellbeing support with a trained wellbeing practitioner, who will provide confidential, one-to-one social, emotional and psychological support over a series of sessions.
We also have many self-help resources to help you manage the impact of living with a condition which affects your appearance. Our guides cover topics from self-esteem, confidence and mental health to managing other people’s reactions and working with a visible difference. Have a look at the whole set here.
You don’t have to change your appearance to fit in with other people’s expectations. However, some people decide that reducing the visible signs of their melasma is the best option for them. Our Skin Camouflage Service may be able to help reduce the appearance of patches caused by melasma. Our practitioners use creams and powders to match the colour of the affected area with the surrounding skin.
Here at Changing Faces, we offer other support services in addition to our Skin Camouflage Service, counselling and wellbeing support and self-help guides:
Please contact our Support and Information Line if you are interested in accessing our services. As well as providing a gateway to other forms of support, our friendly team can offer support calls for you to talk about the impact of melasma on your life.
Guidance, support and advice is also available from other organisations. Please follow the links to their websites to learn more.
BAD specialises in the practice, teaching, training and research of dermatology (the branch of medicine dealing with the skin). They offer patient information on melasma, general advice for people with skin conditions and opportunities to take part in research for skin conditions.
The British Skin Foundation provides patient information on skin conditions including melasma. It also offers number of online forums for people with skin conditions to talk to other patients and medical experts, and opportunities to raise awareness of acne and its impacts by sharing your story.
A national, highly specialist psychological service based at North Bristol NHS Trust, supporting adults (16+) with appearance-related distress. They can provide face-to-face and remote support via NHS Attend AnyWhere. Please speak to your GP or healthcare professional to discuss a referral.