Melasma: Causes, Triggers, and What Actually Helps

When you see those patchy brown or gray-brown spots on your cheeks, forehead, or upper lip, you’re likely dealing with melasma, a common skin condition characterized by dark, irregular patches on the face, often triggered by hormones and UV exposure. Also known as chloasma, it’s not dangerous—but it can be frustratingly persistent, especially for women in their 30s to 50s. Unlike regular sun spots, melasma doesn’t fade easily with time or basic skincare. It sticks around because it’s rooted in how your skin’s pigment cells respond to hormones and light.

This isn’t just about sunscreen. hormonal changes, like those during pregnancy, from birth control pills, or hormone replacement therapy are major drivers. That’s why it’s sometimes called the "mask of pregnancy." But even if you’re not pregnant, taking hormonal meds or having thyroid issues can trigger it. And once it starts, sun exposure, even minimal or indirect UV light can make it worse. A cloudy day? Doesn’t matter. Melasma doesn’t care. It reacts to any UV rays that reach your skin.

What makes melasma tricky is that many treatments fail because they target the surface, not the cause. Topical creams with hydroquinone, retinoids, or azelaic acid can help—but only if you’re also protecting your skin every single day. Chemical peels and lasers? They can work, but if you skip sun protection afterward, the dark spots often come back stronger. And not all skin tones respond the same way—people with darker skin tones are more prone to melasma and more likely to get post-treatment darkening.

There’s no magic cure, but there are proven ways to manage it. The key is consistency: daily broad-spectrum SPF 30+ (yes, even indoors), avoiding direct sun during peak hours, and choosing skincare that doesn’t irritate your skin. Some people find that switching birth control or addressing thyroid imbalances helps. Others see improvement with prescription topicals or gentle in-office treatments under a dermatologist’s care.

Below, you’ll find real-world guides on how melasma connects to other skin and medication issues—like how certain drugs can worsen pigmentation, why some sunscreens fail, and what supplements or hormonal treatments might help or hurt. These aren’t theory pieces. They’re based on what people actually experience, what studies show, and what works in practice. You’ll find no fluff, no hype—just clear, practical info to help you take control of your skin.