Will Melasma Go Away on Its Own?

Melasma is a common skin condition that causes brown to gray-brown patches primarily on the face, and more specifically on the cheeks, on the forehead, above the upper lip, on the bridge of the nose, and on the chin. 

It’s estimated to affect between 1.5–33% of people, depending on the population.

Melasma occurs primarily in individuals with light brown or darker skin tones, especially in areas that get high sun exposure. Women make up about 90% of cases, perhaps because pregnancy is a common trigger, as is taking hormonal contraceptives or being on hormone replacement therapy.

At Ross Dermatology, board-certified dermatologists Dr. Kim Ross and Dr. Ronald Davis and our team treat melasma at our offices in San Antonio, Seguin, and LaVernia, Texas. We offer multiple options for clearing away the blemishes and restoring a more even skin tone. 

But can melasma go away on its own? Here’s what the experts have to say.

Melasma causes and risk factors

Doctors don’t fully understand why melasma occurs, but they suspect it may be the result of the malfunction of the melanocytes (pigment cells) in the skin, which produce too much color in certain spots. 

Because people with dark skin have more melanocytes, they’re more likely to develop melasma.

General risk factors include:

• Sun exposure — UV rays trigger melasma
• Gender — affects women about nine times more than men
• Pregnancy — affects 15%-50% of pregnant women, possibly due to pregnancy hormones
• Genetics — up to 50% of people with melasma have a close relative with the condition

Potential triggers include:

• Changes in hormones during pregnancy (chloasma)
• Hormone replacement therapy or birth control pills
• Sun exposure
• Some skin care products
• Anti-seizure medications
• Medications that make the skin more sensitive to sun exposure, including retinoids, some blood pressure medications, and certain antibiotics

The primary symptom of melasma is the characteristic hyperpigmentation of the face and neck. There’s no pain associated with it, nor is it a medical concern. Most people seek treatment because they’re unhappy with the blotchy appearance of the blemishes.

Will melasma go away on its own?

Melasma can go away on its own. For example, once a pregnant woman has delivered the baby, and her hormones have returned to normal levels, the blemishes usually fade. But it can take a while, and you may be too self-conscious about your appearance to wait months to years for that to happen.

The first line of treatment for melasma is a topical sunscreen with a high SPF factor. Other formulations that can prove helpful include:

Hydroquinone

Prescription hydroquinone is available as a lotion, cream, or gel. You apply the product directly on the discolored areas, and it works by lightening their color.

Corticosteroids and tretinoin

These also come in creams, lotions, or gels and help lighten the color of the melasma patches.

Combined creams

Known as triple creams, these formulations contain hydroquinone, corticosteroids, and tretinoin together.

Additional topical medications

We may prescribe azelaic acid or kojic acid in addition to, or in place of, any of the topical creams. These both work to lighten the dark areas of skin.

Other treatment options

Topical medications don’t work for everyone, so at Ross Dermatology, we offer other cosmetic procedures to help reduce the appearance of melasma:

• Microdermabrasion
• Chemical peels
• Laser resurfacing
• Light therapy
• Dermabrasion

Some of these options come with side effects or can cause different skin problems, so it’s best to speak with your doctor before starting any treatment..

Will melasma go away on its own? Maybe, but why wait? Ross Dermatology can help reduce the blemishes with one or a combination of effective treatments. To learn more, or to schedule a consultation, call us at any of our locations, or book online today.