Manhattan Dermatology Specialists
  • MIDTOWN 56 W 45TH ST, STE 819 New York, NY 10036
  • UPPER EAST SIDE 983 PARK AVE, STE 1D1 New York, NY 10028
  • UNION SQUARE 55 W. 17TH ST STE 103 New York, NY 10011



If you’ve noticed the appearance of dark patches on your skin, you may have a skin condition called melasma. Your New York dermatologist can diagnose your condition and recommend treatments. There’s nothing to worry about, as melasma is a common condition, it’s not a serious health risk. Melasma is also called chloasma, although some refer to the condition as the “mask of pregnancy.” While it may affect women who are pregnant, it mostly affects women between the ages of 20-50 years old who are not pregnant.

In the United States, experts estimate that six million women have melasma. Around the world, approximately 45 to 50 million women have skin conditions. Melasma may also occur in men, but according to the American Academy of Dermatology, 90 percent of cases involving melasma are women.

The Causes of Melasma

The tan or dark skin coloration of melasma has no known cause, but it is most often linked to:

  • People who experience frequent and prolonged exposure to the sun
  • Pregnant women
  • Women taking birth control pills

Researchers and scientists believe that melasma occurs when melanocytes, which are the cells that produce pigment, become stimulated by estrogen and progesterone (female hormones). This stimulation of pigments produces more melanin when the skin is exposed to the sun’s ultraviolet radiation. Visit an NYC dermatologist who’s familiar with melasma. A good dermatologist knows how to diagnose and treat this condition. With the proper treatment, your symptoms slowly diminish and may go away completely. Once it’s gone, your dermatologist in NYC may suggest wearing sunblock on a regular basis to prevent future outbreaks.

Symptoms to Expect with Melasma

If you find odd skin discoloration, the key symptom that informs you that its melasma is the asymmetrical appearance of brown or gray splotches. The symmetrical splotches appear evenly on both sides of your face, although they can appear on other areas of your body as well. They should be the same size and shape on both sides. These are the signs your New York dermatologist looks for when determining if your condition is melasma. It’s much less common, but skin discoloration may also appear on your neck and forearms. More commonly, it appears on these areas of your face:

  • On your forehead
  • On both cheeks
  • Between your upper lip and your nose
  • On the bridge of your nose
  • On your chin
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Diagnosing Melasma

If you discover facial discoloration, visit your dermatologist in Manhattan. During your appointment, your dermatologist with examine your skin and ask you about your general medical history, including family history, to rule out other skin issues. If you’re a woman, among the questions are those regarding the possibility that you’re pregnant or whether you’ve experienced a spike in hormonal activity. Both of these are triggers for melasma. Sometimes, to correctly diagnose your condition, a dermatology doctor in NYC may use a Wood’s light. It’s a lamp that produces ultraviolet (UV) radiation to shine on your skin. It more easily shows the melasma and the depth of the condition. It’s rare, but in some cases, the dermatologist performs a biopsy taking a tissue sample to rule out more serious issues. Your NY dermatologist may also inquire about the following factors, as they can put you at greater risk for developing melasma:

  • Your ethnicity: People with darker skin, such as Eastern Indian, Middle Eastern, African, African American, and Hispanic, are more prone to develop melasma. Even those with olive-colored skin, such as people of Mediterranean descent, can also get melasma more often than Caucasians.
  • Hormone replacement therapy: If you’ve taken any type of medication or therapy that affects your hormone levels, it may trigger an instance of melasma.
  • Birth control pills: If you’re taking birth control pills, you should know that these can cause a hormone spike, which is often a trigger for melasma.
  • Sun and heat exposure: Being in direct sunlight or heat for extended periods of time exposes you to dangerous UV light that causes melanocytes to produce more pigment. While it’s common knowledge that UV light causes your skin to darken, you may not know that even a slight amount of sunlight or heat can cause melasma to return after it has faded.
  • Specific medications: Certain drugs, such as anti-seizure prescriptions, can make your skin more sensitive to darkening after you’ve been exposed to sunlight. Ask your New York dermatologist if any of the medications you’re currently taking put you at risk for melasma.

How to Treat Melasma

At first, your dermatologist may prescribe a topical melasma treatment containing hydroquinone, corticosteroids, acids, retinoids, or a combination of the ingredients above. These creams help lighten your skin back to normal. Typically, you apply these creams to the discolored patches of skin once or twice per day. Sunscreen can be applied over the lightning cream each morning. Of the four types of melasma, the epidermal type responds best to topical treatment because the pigment in epidermal melasma is near the top layer of the skin’s surface. For more recalcitrant or dermal melasma, a variety of procedures can be performed to help break up and eliminate the pigmentation, such as chemical peels, microdermabrasion, or laser therapy.

Prevention of Melasma

The best way to avoid developing melasma is to limit your time in direct sunlight. If you can’t avoid being in the sun for extended times, make sure you follow these preventative suggestions:

  • Use a potent sunblock, such as one with titanium dioxide or zinc oxide
  • Throw shade on your melasma with a wide-brimmed hat
  • Avoid exposure to heat, i.e., stove, fireplace

Talk to your dermatologist about possible triggers that you may not be aware of. In addition to sunlight and birth control pills, triggers like other medications that stimulate hormones may be causing your condition. Follow your skin doctor’s recommendations and use the medicines as directed.

Important Reminder: This information is only intended to provide guidance, not definitive medical advice. Please consult dermatologist NYC about your specific condition. Only a trained, experienced board-certified dermatology doctor or pediatric dermatologist could determine an accurate diagnosis and proper treatment.

Updated on Mar 7, 2023 by Dr. Susan Bard (Dermatologist), Manhattan Dermatology Specialists Locations: Manhattan Dermatology (Upper East Side) 983 Park Ave, Ste 1D1, NY 10028
(212) 427-8750
Manhattan Dermatology (Midtown) 56 W 45th St, Ste 819, NY 10036
(212) 889-2402
Manhattan Dermatology (Union Square) 55 W 17th St, Ste 103, NY 10011
(212) 378-9984
DISCLAIMER: PLEASE READ CAREFULLY The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs you may be having. An accurate diagnosis and treatment plan should only be made by your physician in order to exclude a serious condition.
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