Melasma

Last reviewed: 18 Apr 2022
Last updated: 22 Feb 2018

Summary

Definition

History and exam

Key diagnostic factors

  • centrofacial, malar, or mandibular distribution of muddy brown to grey hyperpigmentation
More key diagnostic factors

Risk factors

  • female sex
  • Fitzpatrick III to VI skin types
  • UV radiation
  • oral contraceptive pill
  • pregnancy
  • FHx of melasma
  • photosensitising drugs
More risk factors

Diagnostic investigations

1st investigations to order

  • Wood lamp examination
More 1st investigations to order

Investigations to consider

  • skin biopsy
More investigations to consider

Emerging tests

  • reflectance confocal microscopy (RCM)

Treatment algorithm

ACUTE

pregnant

non-pregnant

Contributors

Authors

Laura Korb Ferris, MD, PhD, FAAD
Laura Korb Ferris

Assistant Professor of Dermatology

University of Pittsburgh

Pittsburgh

PA

Disclosures

LKF declares that she has no competing interests.

Maria Liliana Marino, MD

Fellow

Department of Dermatology

Memorial Sloan Kettering Cancer Center

New York

NY

Disclosures

MLM declares that she has no competing interests.

Peer reviewers

Chad M. Hivnor, Major, USAF, MC, FS

Chief

Outpatient & Pediatric Dermatology

59th Medical Wing/ SGOMD

Lackland Air Force Base

San Antonio

TX

Disclosures

CMH declares that he has no competing interests.

Jashin Wu, MD

Chief Dermatology Resident

University of California

Irvine

CA

Disclosures

JW declares that he has no competing interests.

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