Amara Sayed, D.O.

If you have noticed some darkening patches or freckles on your face, or if all of a sudden it looks like you have a mustache on your upper lip, you may be looking at a skin condition called melasma. At Vitalogy Skincare, we aim to help our patients through these often puzzling skin conditions that may seem to appear out of the blue.

What is Melasma?

Melasma is a common acquired skin condition that is a form of hyperpigmentation occurring in response to various triggers, including hormones and sun exposure. It causes brown or blue/gray patches to appear on the skin, most often on areas exposed to the sun, such as your face (forehead, chin, cheeks, and upper lip), but they can also appear on the chest, back, or arms. These patches can look like freckles or like blotchy areas with irregular borders. It is often called the “mask of pregnancy,” as hormonal changes during pregnancy can trigger the condition.

This skin condition is more prevalent in women than men, patients with darker skin types, and those overly exposed to the sun. It can sometimes be transient, such as in pregnant women, as symptoms can disappear once they deliver. Others deal with melasma for years or even the rest of their lives.

Melasma occurs when melanin cells (cells that make the pigment of our skin) become hyperactive and overproduce melanin in certain areas, causing these patches of darker color. Though the exact cause of this overproduction is unknown, certain triggers set off this condition.

Melasma Triggers

  • Sun Exposure – when the sun hits our skin, it triggers the production of melanin, giving us that tan look. Sometimes this effect causes melasma. Patients can sometimes see the patches become darker in the summer and lighter in the winter.
  • Pregnancy – the intense hormonal changes during pregnancy cause melasma in some women. Usually, the symptoms will dissipate once they deliver.
  • Birth control or hormone treatments – these also cause hormonal changes that can trigger melasma.
  • Topical medications and certain skin products – Some of these products can irritate the skin, causing a trigger.
  • Medications – these include oral contraceptives, as well as medications that cause sun sensitivity.
  • Heat – some in-office treatments such as lasers can worsen melasma. Patients prone to melasma should avoid these.
  • Tanning beds have the same effects as exposure to the sun.

Diagnosing Melasma

It is essential to consult an expert in skin conditions, such as a Board-Certified Dermatologist. Melasma may mimic other skin disorders, and having an accurate diagnosis will allow your Dermatologist to work with you to select a treatment that will help you. Typically, melasma can be diagnosed by doing an in-office evaluation. Your Provider might also do a biopsy to rule out another skin condition.

Treatments Available

While there is no one perfect treatment for melasma, all treatments require strict sun protection. There is a direct correlation between the onset of new patches, as well as the darkening of existing patches, and the sun’s UV rays. It is imperative you use sunscreen protection, such as a titanium dioxide or zinc oxide sunscreen with an SPF of 30 or higher. Make sure you reapply frequently and use it daily regardless of the weather, where you’re going, or the time of the year. Yes, it’s that important!

The main goal of treatments is to try to lighten the patches to look more like your regular skin color. These treatments are sometimes more effective when used in a combination of ways. The key is patience since these treatments may take time for you to see any results.

Topical creams such as corticosteroids or hydroquinone cream are used to treat melasma. Hydroquinone is the most common topical cream your Provider may prescribe. It is a bleaching agent used to lighten skin and is often used in combination with other products.

Other treatments include oral medications, chemical peels, laser therapy, microneedling and microdermabrasion. The type of treatment your Provider selects depends on various factors, such as your skin type, how deep the patches are, and where they are located. Your Board-Certified Dermatologist will review your options with you, as well as the risk factors involved.

There is no cure for melasma, but with the help of your Provider, melasma can be managed. If your melasma was triggered by pregnancy or other hormonal reasons, your symptoms might disappear once your pregnancy is over, or if you and your Provider decide to take you off your medication.


At the risk of sounding like an overprotective parent, the use of daily sunscreen is essential. We mentioned earlier the type of sunscreens that will help you do this. Using a wide-brimmed hat can help protect your face, as well as any other sun-protective clothing. Stay in the shade whenever possible, and avoid being outside during peak sun hours (usually between 10 a.m. and 4 p.m.)

You may also use cover-up makeup to give a more even tone to your face. There are a lot of foundations out there that also contain SPF protection, effectively cutting out a step in your skin care routine. Don’t forget to use sunscreen on the rest of your body, though. For sunscreen touchups, powders with SPF make it easy to reapply on your face when you have makeup on.

Lastly, keep your skin healthy by maintaining a good skin care routine. You may want to use a mild skin cleanser to keep skin irritation down and moisturize to protect your skin. Ask your Board-Certified Dermatologist to recommend skin products that work best for you.

If you need more information about melasma or any other skin condition, our highly-qualified Board-Certified Dermatologists and Certified Physician Assistants will help you with diagnosis and treatments. Book an appointment at any of our convenient locations in the Austin area.

ABOUT THE AUTHORAmara Sayed, D.O. – Dr. Sayed is a Board-Certified Dermatologist specializing in medical dermatology, cosmetic dermatology, and skin cancer treatments. She strongly advocates for her patients, focusing on education, prevention, and treatment of dermatological conditions. You can find her at the Bastrop and San Marcos locations. Dr. Sayed enjoys Texas barbecue, the outdoors, and Austin’s active music scene when not working.