Melasma

Last reviewed: 24 Aug 2022
Last updated: 11 Aug 2022

Summary

Definition

History and exam

Key diagnostic factors

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

Risk factors

  • female sex
  • Fitzpatrick III-VI skin types
  • ultraviolet radiation
  • oral contraceptive pill
  • pregnancy
  • family history of melasma
  • photosensitizing 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

nonpregnant

Contributors

Authors

Nazanin Saedi, MD

Director

Laser Surgery and Cosmetic Dermatology

Thomas Jefferson University Hospitals

Philadelphia

PA

Disclosures

NZ has been on the advisory board of Cynosure, Cartessa, Allergan, and Alastin; used equipment from Cynosure and Cartessa; and been a consultant to Allergan and Alastin.

Acknowledgements

Dr Nazanin Saedi would like to gratefully acknowledge Dr Laura Korb Ferris and Dr Maria Liliana Marino, previous contributors to this topic.

Disclosures

MLM and LKF declare that they have 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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