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Melasma Treatment St. Louis

Close-up of melasma patches on cheeks of Asian woman.

Did you know that melasma is more than just a cosmetic concern? It's a common skin condition often linked to hormonal changes and sun exposure that presents as dark patches on your face and arms. Primarily impacting women, especially those with darker skin tones, this pigmentation disorder can be quite distressing and can have a significant impact on self-esteem and confidence.

At Mid-County Dermatology in St. Louis, MO, we have many patients that come see us for answers about this condition. Our St. Louis dermatologists discuss melasma at length in this article.

Melasma Causes and Risk Factors

Melasma is a common skin condition that affects many individuals, particularly women. Hormonal fluctuations, such as those experienced during pregnancy or while taking birth control pills, are known to contribute to melasma. These hormonal changes can trigger an increase in melanin production, leading to the development of dark patches on the skin. It is important for individuals experiencing hormonal changes to be aware of this potential side effect and take necessary precautions.

Another significant risk factor for melasma is sun exposure without adequate protection. Ultraviolet (UV) radiation from the sun stimulates melanocytes in the skin, causing them to produce more pigment. This increased pigmentation can manifest as dark spots or patches on areas of the face exposed to sunlight. Therefore, it is crucial to use sunscreen with a high SPF, wear protective clothing, and limit time spent under direct sunlight.

Certain medications and cosmetics containing irritating ingredients have also been known to trigger melasma in some cases. Ingredients like fragrances or harsh chemicals can cause inflammation in the skin, which may lead to hyperpigmentation. It is advisable for individuals prone to melasma to carefully read labels and avoid products that could potentially aggravate their condition.

Another factor that contributes to the prevalence of melasma is skin type. People with darker skin tones have higher levels of melanin production, which makes them more susceptible to developing this condition. Increased melanin production can lead to hyperpigmentation and uneven skin tone. Therefore, individuals with Fitzpatrick skin types III-VI are at a higher risk of experiencing melasma compared to those with lighter skin tones, according to our St. Louis dermatologists.

Moreover, genetic predisposition plays a role in determining an individual's susceptibility to developing melasma. If someone in your family has had melasma before, you might be at a higher risk of developing it yourself. While genetic predisposition does not guarantee that you will develop melasma, it increases your chances compared to those without a family history of the condition.

Common Locations of Melasma

Melasma tends to appear on areas of the body that are exposed to the sun. The most frequently affected areas include the forehead, cheeks, upper lip, chin, and forearms.

Prevalence of Melasma

The prevalence of melasma varies across different ethnic groups and skin tones. It is more commonly observed among individuals with Asian, Hispanic/Latino, Middle Eastern, Mediterranean, and African descent. These ethnicities often have naturally darker complexions and more active melanocytes that produce melanin. Healthcare providers should be aware of these variations.

To understand the impact of melasma on various populations worldwide, including those with different skin tones, it is important to consult with a healthcare provider. Melasma can affect individuals of all skin tones.

  1. In Asia, melasma affects approximately 40-60% of women in countries like India and China. This skin condition is a concern for many women seeking healthcare providers in these regions.

  2. In Latin America, the prevalence of melasma ranges from 15-50% among women. If you suspect melasma, it is important to consult a healthcare provider who can diagnose melasma accurately.

  3. In Africa: Studies suggest that up to 20% of pregnant women may experience melasma.

  4. In Europe: The occurrence rate is lower than in other regions but still affects a significant number of people.

Melasma is also predominantly found in women, with approximately 90% of cases occurring in females. This gender disparity suggests that hormonal factors, such as changes in skin tone, may play a role in its development. However, men can also develop melasma, albeit less frequently. 

Signs and Symptoms of Melasma

Dark brown or grayish patches on the face are characteristic signs of melasma. These discolored patches typically appear on both sides of the face, showing a symmetrical distribution. While melasma itself does not cause any physical discomfort, it can have a significant impact on one's self-esteem and confidence.

The dark patches of melasma often develop gradually over time and may vary in size and shape. The most common areas affected by melasma include the forehead, cheeks, upper lip, and chin. However, it's important to note that melasma can also occur on other parts of the body exposed to sunlight.

Exposure to sunlight is known to exacerbate melasma symptoms in some cases. After being exposed to the sun's rays, individuals with melasma may notice an increase in pigmentation within their patches. This phenomenon is commonly referred to as "sun-triggered" or "sun-induced" melasma. Therefore, it is crucial for individuals with this condition to take appropriate sun protection measures such as wearing broad-brimmed hats and using sunscreen with a high SPF.

While there are no physical symptoms associated with melasma, some individuals may experience mild skin irritation within the affected areas. This irritation could manifest as itching or a burning sensation but tends to be relatively minor compared to other dermatological conditions.

It is important for individuals who suspect they might have melasma to consult a dermatologist for an accurate diagnosis and appropriate treatment options. Our St. Louis dermatologists can assess the severity of the condition and recommend suitable interventions tailored specifically for each individual case.

Treating Melasma

Avoiding excessive sun exposure is crucial in managing melasma effectively. Sunlight triggers the production of melanin, the pigment responsible for skin color, and can worsen melasmatic pigmentation. To protect your skin from harmful UV rays, it is essential to wear broad-spectrum sunscreen with a high SPF daily. Look for sunscreens that contain ingredients like titanium dioxide, which provide effective protection against both UVA and UVB rays.

In addition to sunscreen, wearing protective clothing such as hats and sunglasses can provide an extra layer of defense against sunlight-induced pigmentation changes. These accessories not only shield your face from direct sunlight but also add a stylish touch to your outfit.

If you suspect you have melasma, it is important to consult with our St. Louis dermatology team for a proper diagnosis. Our dermatologists at Missouri Baptist Medical Center will examine your skin and determine if it is indeed melasma or another condition that may resemble it. They can also advise you on the best course of action based on your specific situation.

Treating underlying hormonal imbalances or discontinuing hormone-based medications may help manage melasma triggered by hormones. Hormonal fluctuations during pregnancy or when taking birth control pills can contribute to the development or worsening of melasma. By addressing these imbalances under our dermatologists' supervision, you may be able to reduce the severity of melasma and prevent future flare-ups.

Various topical treatments are available for managing melasma and lightening dark brown patches on the skin. One commonly used ingredient is hydroquinone, which inhibits melanin production and helps even out skin tone. 

Another effective option is azelaic acid, which have been shown to lighten hyperpigmentation caused by melasma. This ingredient not only reduces melanin production but also has anti-inflammatory properties that can calm irritated skin.

Chemical peels performed by dermatologists can also help manage melasma. These peels involve the application of a chemical solution to the skin, which exfoliates the top layers and stimulates cell turnover. This process can lead to a reduction in melasma pigmentation and promote a more even skin tone.

Tranexamic acid has emerged as a promising treatment option for melasma. This medication helps reduce pigmentation by inhibiting the production of melanin and preventing its transfer to skin cells. It can be taken orally or applied topically, depending on the severity of melasma and the healthcare provider's recommendation.

In addition to professional treatments, there are over-the-counter creams and serums available that can help lighten melasma spots. Ingredients like kojic acid, vitamin C, and niacinamide have been shown to be effective in reducing hyperpigmentation.

Managing melasma requires a comprehensive approach that includes sun protection, medical guidance, and targeted skincare. By following these strategies and working closely with our St. Louisdermatologists, you can effectively manage melasma and achieve a more even complexion. Remember, consistency is key so stick to your skincare routine and protect your skin from excessive sun exposure for optimal results.

Makeup as a Cover-Up for Melasma

Melasma, a common skin condition characterized by brown patches on the face, can be distressing for those who experience it. While there is no cure for melasma, makeup can serve as an effective tool to conceal these patches and boost confidence. By choosing the right products and following a few key steps, individuals with melasma can achieve a flawless complexion.

Foundation and Concealer: Camouflaging Melasma Patches

One of the most crucial aspects of using makeup to cover up melasma is selecting the right foundation and concealer. Opt for products specifically designed for high coverage, as they are formulated to effectively mask discoloration. Cream-based foundations work particularly well for this purpose, as they offer buildable coverage without appearing heavy on the skin.

To apply foundation and concealer effectively, start by cleansing your face thoroughly and moisturizing it with a lightweight product suitable for your skin type. Next, dot small amounts of foundation onto areas affected by melasma and gently blend it outwards using a beauty sponge or brush. Pay extra attention to ensure seamless blending at the edges of the patches.

Neutralizing Dark Pigmentation: Color Correctors

Color correctors can be incredibly helpful in neutralizing dark pigmentation before applying foundation. These products come in various shades that counteract specific colors on the color wheel. For melasma, opt for color correctors with peach or orange undertones to counterbalance the brown pigmentation.

After moisturizing your face and applying primer, dab a small amount of color corrector onto areas affected by melasma using either your finger or a precision brush. Gently blend it into the skin until you achieve an even tone. Follow this step with foundation application for maximum coverage.

Long-Lasting Coverage: Setting Makeup with Translucent Powder

To ensure longevity throughout the day, setting makeup with translucent powder is essential. After applying foundation and concealer, lightly dust a thin layer of translucent powder over your entire face. This step not only helps to set the makeup but also minimizes shine and enhances its longevity on the skin.

Remember to focus on areas prone to oiliness, such as the T-zone. Use a fluffy powder brush for an even application, and gently press the powder onto the skin rather than swiping it. This technique ensures that the makeup stays in place, allowing you to confidently go about your day without worrying about melasma patches becoming visible.

In addition to using makeup as a cover-up for melasma, adopting other protective measures can help prevent further darkening of the patches. Wearing a wide-brimmed hat when exposed to sunlight provides extra protection against harmful UV rays that can exacerbate melasma. Moreover, incorporating sunscreen into your daily skincare routine is crucial in safeguarding your skin from epidermal damage.

By utilizing cosmetics strategically and selecting products suited for brown skin tones, individuals with melasma can effectively camouflage their patches and restore their confidence. Remember to experiment with different techniques and products until you find what works best for you. With dedication and a little bit of practice, achieving a flawless complexion is within reach for those dealing with melasma.

Melasma Prevention Strategies

Applying sunscreen daily with an SPF of 30 or higher is crucial in preventing melasma development or worsening. Sunscreen acts as a protective barrier between your skin and the harmful UV rays emitted by the sun. By diligently applying sunscreen, you can significantly reduce your risk of developing melasma patches. Make sure to choose a broad-spectrum sunscreen that shields against both UVA and UVB rays for maximum protection.

Seeking shade during peak sun hours (10 am to 4 pm) reduces exposure to harmful UV rays. When the sun is at its strongest, it's important to find shelter under trees, umbrellas, or any other available shade. By limiting your time in direct sunlight during these hours, you can minimize the chances of triggering melasma or exacerbating existing patches.

Wearing wide-brimmed hats and protective clothing provides additional protection against sunlight-induced pigmentation changes. A hat with a wide brim not only adds a fashionable touch to your outfit but also shields your face from direct sunlight. Wearing long-sleeved shirts and pants made from lightweight fabrics can help protect other areas of your body prone to melasma. Consider opting for clothing specifically designed with built-in UPF (Ultraviolet Protection Factor) for enhanced sun protection.

Avoiding excessive heat from saunas or hot baths may help prevent triggering or exacerbating melasma. Heat can stimulate melanocyte activity, leading to increased production of pigmentation agents in the skin. To minimize this risk, it's advisable to limit prolonged exposure to high temperatures and opt for cooler activities instead.

In addition to these measures, there are various skincare tips you can incorporate into your routine:

  • Cleanse your face gently using mild cleansers suitable for sensitive skin.

  • Avoid harsh scrubs or exfoliants that could potentially irritate your skin.

  • Use moisturizers that contain ingredients like hyaluronic acid or ceramides to keep your skin hydrated.

  • Incorporate antioxidants into your skincare routine, such as vitamin C or green tea extract, to help protect against free radicals.

  • Consider using topical treatments recommended by a healthcare professional, such as hydroquinone or retinoids, to target melasma patches.

While prevention strategies play a crucial role in managing melasma, it's important to note that individual experiences may vary. Some people may find success with these methods alone, while others may require additional procedures or treatments. If you're concerned about melasma or have persistent patches despite preventive measures, consult with a dermatologist who can guide you through suitable options.


At Mid-County Dermatology in St. Louis, MO, we specialize in treating melasma, a common skin condition that affects self-confidence. Our experienced team offers effective management and treatment options - call us or text us at 314-994-0200 to schedule your melasma consultation. You can also schedule your appointment online.

Melasma can be triggered by hormonal changes, sun exposure, and genetics. We help patients prevent and manage melasma by identifying causes and risk factors.

Our approach involves preventive measures, self-care tips, and treatments. Protecting the skin from sun exposure and using topical creams with hydroquinone or retinoids can lighten dark patches. Procedures like chemical peels may be recommended.


1. Can melasma go away on its own?

Melasma may fade on its own, especially if it is triggered by hormonal changes during pregnancy or birth control use. However, it often requires treatment for significant improvement.

2. Are there any natural remedies for melasma?

While some natural remedies like lemon juice or apple cider vinegar may have anecdotal benefits, they are not scientifically proven to effectively treat melasma. It is best to consult with a dermatologist for appropriate treatment options.

3. Will using sunscreen alone help in managing melasma?

Sunscreen is an essential part of managing melasma as it helps protect the skin from harmful UV rays that can worsen the condition. However, sunscreen alone may not be sufficient, and additional treatments may be needed for optimal results.

4. Can men get melasma too?

Yes, although women are more commonly affected by melasma due to hormonal factors, men can also develop this condition.

5. Can stress worsen melasma?

Stress has been known to trigger or exacerbate various skin conditions, including melasma. Managing stress levels through relaxation techniques or seeking support can help minimize its impact on the condition.

These FAQs provide answers to common questions about melasma that can influence purchase decisions and help individuals make informed choices regarding their skincare routines and treatments.

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