Melasma is recognized as a skin condition presenting as brown spots or patches on the face of adults. The most common sites on the skin are the cheeks, bridge of the nose, forehead, jawline and upper lip. It also affects both sides of the face. Melasma typically occurs in women, around 90%.

Individuals with a darker pigment, mainly, Hispanic, Indian, Asian, Middle East and Northern Africa tend to be more affected by melasma.

The exact cause of melasma is complex. People with a known family history of melasma are more prone to develop melasma themselves. It is commonly seen in pregnant women, and is called chloasma also known as “mask of pregnancy.” Research shows birth control pills may play a role. Sun exposure and worsen or escalate the condition, even a few minutes a day can cause recurrences.

Melasma is a chronic condition. The most successful formulation has been a combination of hydroquinone, tretinoin, and moderate potency topical steroid. This has been found to result in improvement or clearance in up to 60–80% of those treated. Year-round sun protection and avoidance are required. {Melasma, Dermnet}