What Triggers Melasma?

What is Melasma?

Skin pigmentation and dark patches are typical symptoms of melasma, a common skin condition. Since it usually occurs during pregnancy, it's also called chloasma or "the pregnancy mask." Melasma is most commonly found in women, although men may be affected as well.
A number of factors may contribute to the development of melasma, although its exact cause is not fully understood. Melasma can be caused by hormonal changes, such as those associated with pregnancy or medications like birth control pills. UV (ultraviolet) radiation stimulates the production of melanin (the pigment responsible for skin color) and can aggravate existing melasma or trigger it. A person's susceptibility to melasma is also influenced by genetics and ethnicity. For instance, melasma is more likely to affect people with darker skin tones and is more common in women of Latin, Asian, North African, and Indian descent. 

Triggers of Melasma 

Melasma can be triggered by several factors. Some of the most common triggers include:

1. Sun exposure

Ultraviolet (UV) light from the sun is one of the most common triggers of melasma. This is why melasma often appears on areas of the skin that are exposed to the sun, such as the face and neck. Sun exposure triggers melasma because ultraviolet (UV) light from the sun affects the cells that control pigment (melanocytes) and triggers the body to produce more melanin.

2. Hormones

Melasma can be triggered by hormonal changes. A rise in hormone levels, estrogen and progesterone, which occurs during pregnancy or when a woman is taking birth control pills, is thought to trigger melasma. The use of birth control pills can increase a woman's risk of developing melasma due to the hormones estrogen and progesterone present in the pill. These hormones stimulate the production of melanin, which can lead to dark patches on the skin.

3. Medications 

It is possible for some people to develop melasma after taking certain medications. Antiseizure medications, birth control pills, and antibiotics are among these. This is because these medications can cause an increase in the production of melanin, which is the pigment that gives the skin its color. This melanin is what causes melasma.

4. Genetics 

Melasma is most commonly diagnosed in patients with a family history. As a result, if someone in your family has melasma, you are at risk of developing it yourself. Melasma may be more common in people with certain genetic factors that affect how their skin responds to hormonal changes and sun exposure. For example, some people with melasma carry a genetic variant of the MC1R gene, which affects their skin's response to ultraviolet radiation. The MC1R gene provides instructions for making a protein called the melanocortin receptor. This receptor plays a vital role in normal pigmentation.

5. Thyroid 

The thyroid gland can be disrupted by thyroid disorders such as hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid), which can lead to hormonal imbalances. In turn, these hormonal imbalances are thought to cause or worsen melasma. Thyroid hormones control the body’s metabolism and its production of melanin, the pigment that gives skin and hair its color. An imbalance in thyroid hormones can cause an overproduction of melanin, resulting in an increased risk of developing melasma.

Treating and Preventing Melasma

Treating and preventing melasma involves a combination of lifestyle modifications, sun protection, skincare, and medical interventions. It is best to consult with an  experienced doctor who can provide personalised recommendations based on your specific case and your goals. However, some general approaches to treating and preventing melasma include:

Sun Protection

Protecting your skin from the sun is crucial in managing melasma. Wear broad-spectrum sunscreen with a high SPF (at least 30) every day, even on cloudy days. Reapply sunscreen every two hours and use protective clothing, hats, and sunglasses to shield your skin from harmful UV rays.


Use gentle skincare products suitable for your skin type. Avoid harsh cleansers or exfoliants that can irritate the skin and worsen melasma. Look for skincare products that contain ingredients like hydroquinone, tretinoin, azelaic acid, or kojic acid, which can help in lightening the dark patches over time. However, it's important to use these products under the guidance of a dermatologist.

Topical Treatments

Prescription creams or ointments containing ingredients such as hydroquinone, tretinoin, corticosteroids, azelaic acid, or kojic acid may be recommended by a doctor experienced in the treatment of melasma. These topical treatments work by inhibiting melanin production, promoting skin lightening, and reducing pigmentation. Follow your doctor's's instructions on how to use these treatments correctly.


In some cases, clinical procedures may be recommended to treat melasma. These include:

Chemical Peels

A chemical solution is applied to the skin, causing it to exfoliate and peel off. This process helps in reducing pigmentation and promoting skin renewal. Superficial or medium-depth peels are commonly used for melasma.

Laser Therapy

Laser treatments, such as fractional lasers, can be used to target melasma. These procedures work by breaking down excess pigmentation and stimulating collagen production for skin rejuvenation. However, laser therapy is mostly used as an additional treatment on top of other treatments for melasma such as medication or skin lightening agents.

Hormone Management

If hormonal factors are contributing to melasma, such as during pregnancy or due to birth control pills, discussing hormone management options with a healthcare professional or dermatologist may be beneficial. A doctor would be able to either prescribe you with hormone replacement therapy or other medications to help tackle the issue of hormonal imbalance in your body.

Avoiding Triggers

Identify and avoid triggers that worsen melasma. This includes minimizing sun exposure, protecting your skin with sunscreens and protective clothing, and discontinuing the use of skincare products that irritate your skin.

It is important to note that melasma is a chronic condition, and it may take time and consistency to see significant improvements with patience and consistency, your treatment regimen and consult with a healthcare professional for personalized advice and recommendations.