What Is Melasma? Dark Facial Patches and When to See a Doctor
2026-08-02
Medically reviewed by Dr. Abdul Hadi Jafri — استشاري
Melasma is an acquired pigmentation condition that causes symmetric brown-to-grey patches, usually on the cheeks, forehead, and upper lip. It is not medically harmful in itself, but it is chronic, prone to returning, and can affect confidence. Daily sun protection is central to managing pigmentation.
What is melasma and how does it appear on the face?
Melasma is a form of hyperpigmentation, meaning an increase in the skin's natural pigment known as melanin. It usually appears as brown patches that tend to be symmetric between the two sides of the face, concentrated in the most light-exposed areas: the cheeks, forehead, and upper lip, and sometimes the nose and chin. The edges of the patches may be soft rather than sharp, and they are not usually accompanied by itching, pain, or a change in skin texture.
Melasma is an acquired condition, meaning it develops during a person's life rather than being present from birth. It is a surface change in colour without a change in skin tissue, which sets it apart from conditions that cause bumps, roughness, or a change in texture.
Who is more likely to develop melasma?
Melasma affects women markedly more often than men and is more common in people with darker skin tones, including many patients in Saudi Arabia and the region. Men can also develop it, though less often. Melasma often appears during years of hormonal activity, which explains its link to certain life stages in women.
What causes melasma and what triggers it?
A full understanding of what causes melasma is still being studied, but several factors are known to be linked to it:
- Sun exposure: Ultraviolet rays and visible light are among the main factors that stimulate pigment cells and increase pigmentation.
- Pregnancy: Melasma appears in some women during pregnancy, where it is known as melasma of pregnancy (chloasma), and it is linked to the hormonal changes of that stage.
- Hormonal factors: Hormonal changes in general are associated with the appearance or worsening of melasma in some women.
The combination of individual predisposition with light exposure and hormonal factors explains much of why melasma appears, even though the fine details remain under research.
Is melasma dangerous to health?
Melasma is benign: it is not medically dangerous and does not turn into a more serious disease. It is chronic and can return after improving, and it may affect confidence in appearance. Not every facial pigmentation is melasma; some skin changes need medical assessment to rule out other causes.
Why is sun protection the foundation of managing any pigmentation?
The American Academy of Dermatology (AAD) advises that daily broad-spectrum sun protection is the foundation of managing any skin pigmentation condition, including melasma. Light exposure is one of the strongest factors that stimulates pigmentation and makes it more visible and longer-lasting.
What does research say about the options under study?
A network meta-analysis pooled data from 9 randomized controlled trials involving 358 participants and examined injectable approaches under study for melasma. It concluded that standardized protocols and longer-term studies are needed before firm conclusions can be reached. A dermatologist should therefore decide how to approach melasma after examination; these findings are not a treatment recommendation.
When should you see a doctor?
It is worth consulting a dermatologist when:
- Any facial pigmentation is new, asymmetric, changing in size or colour, raised above the skin surface, or of uncertain cause; this needs a professional assessment to rule out other causes.
- Before trying strong lightening products or non-prescribed remedies; products used without supervision can irritate the skin and make pigmentation worse rather than better.
- Pigmentation affects your emotional well-being or confidence.
This content was medically reviewed by Dr. Abdulhadi Jfri — Dermatology, Avant Clinics. Review date: 16 July 2026.
Source: Network meta-analysis published in Aesthetic Surgery Journal, 2025 — DOI: 10.1093/asj/sjaf097
Frequently asked questions
Does melasma go away after pregnancy?
Melasma of pregnancy may improve in some women after delivery as hormones settle, but it can persist or return in others, especially with sun exposure. A medical assessment helps understand the condition and set a suitable follow-up plan.
Is melasma dangerous or contagious?
Melasma is a benign condition that is neither dangerous nor contagious, though it is chronic and prone to returning. Even so, any pigmentation that is new, changing, or of uncertain cause deserves a medical assessment to rule out other causes.
Why is sun protection important with melasma?
Because light exposure is one of the strongest factors that stimulate pigmentation and make it more visible and longer-lasting. This is why the American Academy of Dermatology advises that daily broad-spectrum sun protection is the foundation of managing any pigmentation.
Can I use lightening products without seeing a doctor?
It is better to consult a dermatologist before trying strong lightening products, because products used without supervision can irritate the skin and make pigmentation worse rather than better.
When should I see a dermatologist for facial pigmentation?
When pigmentation is new, asymmetric, changing, raised, or of uncertain cause, before trying strong lightening products, or when the pigmentation is affecting your emotional comfort.