What are the Best Treatments for Melasma?

Melasma  treatment
Medically reviewed by Dr. Ola Tarabzuni

What is Melasma?

Chloasma, another name for melasma, is a skin ailment that frequently affects people and results in dark patches on the face, particularly on the cheeks, forehead, nose, and upper lip. Though it can affect anyone, it is more prevalent in women and those with darker skin tones.

It is unclear what causes melasma exactly. Nonetheless, it is thought to be influenced by genetics, sun exposure, and hormonal changes, such as those that take place during pregnancy or when taking birth control pills.

Melasma can be distressing for some people, but it is a benign condition with no health risks. However, treating it can be challenging and may recur even after successful treatment. Treatment options include topical creams, chemical peels, microdermabrasion, and laser therapy. You must consult a dermatologist to choose the best action for your situation. A high SPF broad-spectrum sunscreen is also advised to stop the afflicted skin from getting darker.

What Causes Melasma

The causes of melasma are not fully understood and can vary from person to person. However, the following are some of the known causes of melasma:

  • Hormonal changes: Hormonal changes are considered the most common cause of melasma. This includes pregnancy, oral contraceptives, hormone replacement therapy, and thyroid disease.
  • Sun exposure: Exposure to the sun’s ultraviolet (UV) rays is a significant risk factor for melasma. UV rays can trigger melanocytes to produce excess melanin, leading to melasma’s development.
  • Genetics: Evidence shows that hereditary factors may influence melasma development. Some people may have a higher hereditary propensity to develop melasma.
  • Skin types: Melasma is more common in people with darker skin types, such as Fitzpatrick skin types III to VI.
  • Cosmetics and skin care products: Certain cosmetics and skin care products can cause a phototoxic reaction, which can lead to the development of melasma.
  • Medications: Certain medications, such as oral contraceptives, hormone replacement therapy, and anticonvulsants, have been associated with the development of melasma.
  • Medical conditions: Melasma can develop due to several ailments, including thyroid disease and problems of the adrenal glands.

It’s important to note that while these are the known causes of melasma, the exact cause of the condition may be challenging to identify in some cases. Additionally, multiple factors may contribute to the development of melasma in an individual.

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What are the Symptoms of Melasma?

A common skin ailment known as melasma causes dark, asymmetrical patches of skin to appear on the face, usually on the cheeks, forehead, nose, chin, and upper lip. The patches may also appear on other sun-exposed body areas, such as the neck and arms. The symptoms of melasma can vary from person to person and may include the following:

  • Hyperpigmentation: The primary symptom of melasma is hyperpigmentation, which appears as dark patches on the skin. These patches are typically brown or gray-brown and have an irregular shape.
  • Symmetrical appearance: Melasma often appears in a symmetrical pattern on the face, meaning that the patches are present on both sides of the face.
  • Border: The borders of the patches are typically well-defined, although they may be irregular in shape.
  • Size: The patches can range in diameter from a few millimetres to several centimetres.
  • Texture: The skin in the affected area may feel slightly raised or rough to the touch.
  • No other symptoms: Melasma does not cause any other symptoms, such as itching, pain, or irritation.

It is important to note that while melasma is a harmless skin condition, it can be a source of embarrassment or self-consciousness for some people. 

Are Freckles Melasma?

Freckles and melasma are not the same, although they can appear similar on the skin. Freckles are small, flat, brown spots suddenly appearing on the skin, especially in areas frequently exposed to the sun. They are usually round, have a uniform colour, and can be found on any skin type. Freckles are caused by an increase in the production of melanin, which is triggered by exposure to the sun.

Conversely, melasma is a larger patch of darkened skin that typically appears on the face, neck, or arms. The patches are usually irregular in shape and have a brown or gray-brown colour. Melasma is also caused by an increase in the production of melanin, but it is triggered by hormonal changes or sun exposure.

While freckles and melasma are different, they can be triggered by sun exposure. Freckles can fade or darken depending on the amount of time spent in the sun, while melasma can be aggravated or worsened by exposure to the sun’s UV rays. It’s essential to protect the skin from the sun to prevent the development of freckles and melasma.

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What Questions Might my Healthcare Provider ask to Diagnose Melasma?

To diagnose melasma, a healthcare provider will typically ask about your medical history and physically examine the affected skin. The following are some of the queries that your healthcare provider might ask you during the diagnostic process:

  • Have you noticed any dark or discoloured patches on your skin, particularly on your face?
  • When did you first notice the discoloration, and has it changed over time?
  • Have you experienced hormonal changes recently, such as pregnancy or starting or stopping oral contraceptives or hormone replacement therapy?
  • Have you been exposed to the sun without protection or recently started using new skincare or cosmetic products?
  • Have you noticed other skin changes or symptoms, such as itching, redness, or swelling?
  • Do you have any medical conditions, or are you taking any medications contributing to the discoloration?

Your healthcare provider may also use a particular device called a Wood’s lamp to examine the affected skin. A Wood lamp emits UV light that can help to highlight areas of hyperpigmentation that might not be visible to the naked eye.

A skin biopsy may occasionally be required to confirm the diagnosis of melasma and rule out other illnesses that could cause the same symptoms. But, a physical examination and a study of your medical history are typically enough to determine whether you have melasma.

How to Get Rid of Melasma?

Although melasma can be a problematic and obstinate ailment to cure, several solutions could assist in lessening the visibility of dark patches on the skin. Among the melasma treatments are

Topical medications

A healthcare provider may recommend prescription creams containing hydroquinone, tretinoin, or corticosteroids to help lighten the skin and reduce the appearance of hyperpigmentation.

Chemical peels

can help to exfoliate the skin’s outer layers and reduce melasma’s appearance. Your healthcare provider may recommend a mild or medium-strength chemical peel, depending on the severity of your condition.

Microdermabrasion

Melasma’s appearance may be lessened via microdermabrasion, which employs a device to gently remove the top layer of dead skin cells.

Laser therapy

It can effectively reduce melasma’s appearance, particularly in cases that do not respond to other treatments. However, laser therapy should only be performed by a trained professional.

Sun protection

Protecting the skin from sun exposure is essential to treat and prevent melasma. Use safety gear, including helmets, long sleeve shirts, and a broad-spectrum sunscreen with an SPF of at least 30.

Combination therapies

Sometimes, a combination of medicines may be recommended to treat melasma. This may include a variety of topical medications, chemical peels, and laser therapy. Combination therapy can be particularly effective for individuals with more severe or persistent cases of melasma. Here are some examples of combination therapies that may be recommended for treating melasma:

  • Topical medications and chemical peels: A healthcare provider may recommend using a combination of prescription creams and chemical peels to help reduce the appearance of hyperpigmentation. This combination can be particularly effective for individuals with mild to moderate melasma.
  • Topical medications, chemical peels, and laser therapy: For more severe cases of melasma, a healthcare provider may recommend a combination of prescription creams, chemical peels, and laser therapy. This combination can help target deeper skin layers and reduce the appearance of stubborn patches of hyperpigmentation.
  • Sun protection and topical medications: Sun protection is essential to any melasma treatment plan, as exposure to UV radiation can worsen the condition.
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How to Treat Melasma on the Face?

Melasma, a common skin ailment on the face, causes brown or gray-brown areas. The situation is more common in women and is often associated with hormonal changes, sun exposure, and genetic factors. Although there is no cure for melasma, there are several treatment options that can help to improve the appearance of the skin.

Here are some ways to treat melasma on the face:

  • Sun protection: Protecting skin from the sun is crucial. Outside, use protection such as a broad-brimmed hat and sunscreen with an SPF of 30 or higher.
  • Topical treatments: The appearance of melasma can be lessened using a variety of therapies, including hydroquinone, tretinoin, and azelaic acid. These procedures can be applied directly to the afflicted areas and lighten the skin.
  • Chemical peels: Chemical solutions may be applied to the skin during chemical peels, causing the skin to exfoliate and peel. Removing the outermost layer of skin that contains the pigmentation can assist in lessening the appearance of melasma.
  • Microdermabrasion: Microdermabrasion is a non-invasive treatment that involves using a device to exfoliate the skin. This can help to remove the top layer of skin and reduce the appearance of melasma.
  • Laser therapy: Laser therapy is a more invasive treatment option that involves using a laser to target the pigmentation in the skin. This treatment is typically reserved for severe cases of melasma and should only be performed by a trained professional.

Prevention for Melasma

It can be challenging to stop melasma from forming or getting worse. However, there are certain things you can take to lower your risk or manage the condition:

  • Use sun protection: Sun exposure significantly contributes to melasma, so protecting your skin from the sun is crucial. Use broad-spectrum sunscreen with an SPF of 30 or higher, wear a wide-brimmed hat, and avoid prolonged sun exposure during peak hours.
  • Avoid hormonal triggers: Hormonal changes can trigger melasma, so avoid hormonal medications or treatments when possible. This includes birth control pills, hormone replacement therapy, and drugs that affect hormone levels.
  • Be careful with skincare products: Some skincare products, particularly those that contain fragrances or harsh chemicals, can irritate the skin and worsen melasma. Stick with gentle, fragrance-free products, and avoid products that contain hydroquinone or other potentially irritating ingredients without the advice of a healthcare professional.
  • Manage stress: Stress can activate hormonal changes that may contribute to melasma, so managing stress can be helpful. Consider relaxation techniques like meditation, deep breathing, or yoga.
  • Treat underlying conditions: Some underlying medical conditions, like thyroid disorders or autoimmune diseases, can contribute to melasma. If you have an underlying medical condition, work with your healthcare provider to manage it effectively.

Preventing or managing melasma often requires lifestyle changes, skincare, and medical treatment. If you are concerned about melasma or other skin conditions, consult a dermatologist or healthcare provider about developing an individualized plan that works for you.

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What Makes Melasma Worse?

Many factors can cause or exacerbate melasma, a skin disorder that results in dark, uneven skin regions. The following things can aggravate melasma:

  • Sun exposure: Sun exposure is one of the most significant triggers for melasma. The UV rays from the sun can stimulate the production of melanin, which causes the skin to darken. This is why melasma often appears on skin areas commonly exposed to the sun, such as the face, neck, and arms. To prevent melasma from worsening, it’s essential to protect the skin from the sun by wearing sunscreen and protective clothing and avoiding prolonged exposure during peak hours.
  • Hormone changes: Melasma can be brought on by or made worse by hormonal changes, such as those that take place during pregnancy or menopause. This is because hormonal changes may impact the skin’s ability to produce melanin. The “mask of pregnancy” or chloasma is the name for this type of melasma. Changing hormone levels, birth control medications and hormone replacement therapy can cause or worsen melasma.
  • Skincare products: Certain skincare products, particularly fragrances or harsh chemicals, can irritate the skin and worsen melasma. Using skincare products incompatible with your skin type can also decline the condition. Be sure to use gentle, fragrance-free products designed for your skin type to avoid further irritation.
  • Heat: Heat can trigger melasma by causing the blood vessels in the skin to dilate and produce more melanin. Hot baths, saunas, or prolonged exposure to heat sources can cause this. To prevent melasma from worsening, avoiding excessive heat exposure and maintaining a comfortable temperature in your environment is essential.
  • Genetics: Melasma can be hereditary, so you may be more prone to it if you have a family history. While you can’t change your genetics, knowing your family history can help you take steps to prevent or manage melasma.

Overall, to prevent melasma from worsening, it’s essential to protect your skin from the sun, avoid hormonal triggers, use gentle skincare products, and avoid excessive heat exposure. If you have melasma, you must work with a dermatologist or healthcare provider to develop an individualized treatment plan that addresses your specific triggers and needs.

Do Certain Foods affect Melasma?

While no direct evidence suggests that certain foods affect melasma, some studies suggest that a healthy diet may help improve overall skin health and reduce the risk of skin damage that can contribute to melasma. Some dietary tips may help support skin health:

  • Antioxidants: Foods rich in antioxidants, such as fruits, vegetables, and whole grains, may help protect the skin from free radical damage and reduce inflammation. Examples include berries, leafy greens, tomatoes, and citrus fruits.
  • Omega-3 fatty acids: These fats are crucial for skin health and can assist in lessening inflammation. Fatty fish like salmon, mackerel, sardines, flaxseeds, chia seeds, and walnuts are foods rich in omega-3 fatty acids.
  • Vitamin C: Vitamin C is necessary for synthesizing collagen, which keeps the skin elastic and tight. Citrus fruits, strawberries, kiwis, and bell peppers are foods strong in vitamin C.
  • Zinc: Zinc is essential for skin health and helps support the immune system. Zinc-rich foods include oysters, beef, chicken, nuts, and seeds.
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Risk Factors for Melasma

Everyone is susceptible to the common skin ailment melasma. However, some people are more likely to get it than others. The following are some melasma risk factors:

Hormonal changes

Melasma can be brought on by hormonal changes, such as those that occur after menopause, pregnancy, or when taking birth control pills or hormone replacement therapy. This is because hormonal changes may impact the skin’s ability to produce melanin.Melasma mustache, also known as chloasma or “mask of pregnancy,” is a type of hyperpigmentation that appears as brown or gray-brown patches on the upper lip and sometimes the cheeks. It is more commonly seen in women, especially during pregnancy or while taking hormonal contraceptives, but it can also affect men.

Sun exposure

Sun exposure is a significant risk factor for melasma. The sun’s ultraviolet (UV) rays can trigger melanin production in the skin, leading to melasma development. Here are some ways that sun exposure can contribute to melasma:

  • UV radiation. Exposure to UV radiation from the sun can trigger the production of melanin in the skin, which can worsen existing melasma or trigger new patches of discoloration.
  • Sunburns. Sunburns can damage the skin and lead to the development of melasma. People with a history of sunburns or skin easily damaged by the sun are more prone to developing melasma.
  • High altitudes. People who live at high altitudes are more prone to developing melasma because the sun’s UV rays are more intense at higher elevations.
  • Reflections. UV rays can reflect off surfaces like water, sand, and snow, increasing the risk of sun damage and melasma.

Protecting your skin from the sun’s harmful UV rays is essential to prevent exposure from worsening melasma. Here are some tips for sun protection:

  • Wear protective clothing. Wear hats, long sleeves, and pants to cover up as much skin as possible.
  • Use sunscreen. Use a broad-spectrum sunscreen with an SPF of at least 30 and reapply every 2 hours or more frequently if you are swimming or sweating.
  • Seek shade. Stay in the shade, especially during peak sun hours from 10 a.m. to 4 p.m.
  • Avoid tanning beds. Tanning beds emit UV radiation, increasing the risk of sun damage and melasma.

Skin type

Skin type is another important risk factor for melasma. People with darker skin tones, like those of Hispanic, Asian, or Middle Eastern descent, are more prone to developing melasma. This is because they have more active melanocytes, which are the cells that produce melanin.

Melasma is more common in people with skin types with more active melanocytes, which means they produce more melanin in response to specific triggers like hormonal changes and sun exposure. People with Fitzpatrick skin types III, IV, and V are more likely to develop melasma.

In addition to having more active melanocytes, people with darker skin types may also be more susceptible to UV radiation from the sun. This means sun exposure can trigger or worsen melasma in people with darker skin types.

If you have a darker skin type and are concerned about melasma, protecting your skin from the sun’s harmful UV rays is vital by wearing protective clothing, broad-spectrum sunscreen and seeking shade during peak sun hours. It’s also essential to work with a dermatologist or healthcare provider to determine the underlying cause of your melasma and develop an individualized treatment plan.

Genetic predisposition

It is a risk factor for developing melasma. While the exact genes contributing to melasma are not fully understood, research has suggested that the condition may have a genetic component. Studies have revealed that there is a higher prevalence of melasma in certain ethnic groups, such as those of Hispanic, Asian, or Middle Eastern descent, which suggests that genetics may play a role. In addition, research has found that certain genetic variations in genes involved in melanin production may increase the risk of developing melasma. For example, one study found that variations in the MC1R gene involved in melanin synthesis were associated with an increased risk of developing melasma.

  • Gender. Women are more likely to develop melasma than men. This is thought to be related to hormonal changes during pregnancy, menopause, and the use of birth control pills.
  • Skincare products. Certain skincare products, particularly fragrances or harsh chemicals, can irritate the skin and worsen melasma. Using skincare products incompatible with your skin type can also decline the condition.
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Medications for melasma

Certain medications can also increase the risk of developing melasma. These medications can cause a disease known as drug-induced melasma. Some examples of drugs that can contribute to melasma include

  • Hormonal medications. Hormonal medications such as birth control pills, hormone replacement therapy, and certain fertility medications can trigger the development of melasma. This is because these medications can cause hormonal changes that stimulate melanin production in the skin.
  • Photosensitizing medications. Certain medications can make the skin more sensitive to the sun, increasing the risk of melasma. Examples of photosensitizing drugs include certain antibiotics, antihistamines, and antidepressants.
  • Chemotherapy drugs. Chemotherapy drugs can cause changes to the skin, including the development of hyperpigmentation and melasma.

You must talk to your healthcare provider if you take medications and are concerned about your risk of developing melasma. They may be able to adjust your medications or provide recommendations for protecting your skin from the sun. It’s also important to use sun protection measures, such as wearing protective clothing and sunscreen, when taking medications that can increase the risk of melasma.

Complications

Melasma is a cosmetic condition that does not typically cause physical health problems. However, it can significantly impact a person’s self-esteem and quality of life. People with melasma may feel self-conscious about their appearance and avoid social situations or activities requiring them to be in the sun.

In addition, melasma can be challenging to treat and may not respond well to conventional treatments. This can be frustrating for people seeking to improve their skin’s appearance.

While melasma itself is not harmful, it is essential to monitor any changes in the appearance of the skin. In rare cases, melasma can indicate an underlying medical condition, such as thyroid or Addison’s. 

Possible complications of melasma

Melasma is a condition that does not typically lead to complications. However, it can significantly impact a person’s emotional and mental well-being, leading to low self-esteem and social anxiety.

In addition, melasma can be challenging to treat and may not respond well to conventional therapies, which can be frustrating for individuals seeking to improve the appearance of their skin. While melasma is not harmful, it is essential to monitor any changes in the formation of the skin. In rare cases, melasma can indicate an underlying medical condition, such as thyroid or Addison’s disease. 

Long-term outlook

The long-term outlook for melasma is generally reasonable. While melasma can be a stubborn condition that may take time and effort to treat, it is not harmful and does not typically lead to severe health problems.

In some cases, melasma may fade on its own without treatment. However, many people require ongoing treatment to manage their condition and maintain the appearance of their skin.

It’s essential to remember that melasma can be a chronic condition that may require ongoing management. This means that even if the appearance of your skin improves with treatment, you may need to continue using sun protection and other preventive measures to prevent a recurrence of melasma.

If you have melasma, it’s essential to work with a healthcare provider to develop an individualized treatment plan that is safe and effective for you. This may include a combination of topical medications, chemical peels, and laser therapy.

With proper management and ongoing care, most people with melasma can achieve good results and maintain healthy, beautiful skin.

Quality of life impacts

Melasma can significantly impact a person’s quality of life, particularly regarding emotional and mental well-being. Melasma is a visible condition that can be difficult to conceal, and many people with melasma feel self-conscious or embarrassed about their appearance. This can lead to low self-esteem, social anxiety, and depression.

In addition, melasma can be challenging to treat, which can be frustrating for individuals seeking to improve the appearance of their skin. Many people with melasma may try multiple treatments before finding one that works for them, which can be time-consuming and expensive.

Melasma can also be a chronic condition, meaning that even with successful treatment, individuals may need to continue using preventive measures and monitoring their skin for signs of recurrence. This can add to the emotional burden of living with melasma.

Overall, the impact of melasma on an individual’s quality of life can be significant. Healthcare providers must recognize melasma’s emotional and mental health impact and provide support and resources to individuals with this condition. This may include counselling, support groups, and other resources to help individuals cope with the emotional and social challenges of living with melasma.

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When to Consult a Doctor?

You should consult a doctor if you notice any changes in the appearance of your skin, including the development of new patches of hyperpigmentation or changes in the size or shape of existing patches. You should also seek medical treatment if you have any concerns about your melasma or experiencing emotional distress or a reduced quality of life due to your condition.

A healthcare provider can evaluate your skin, help determine the cause of your hyperpigmentation, and recommend appropriate treatment options. In addition, a healthcare provider can help monitor your skin for any signs of complications or underlying medical conditions.

If you are already receiving treatment for melasma but are not seeing improvement, it’s essential to follow up with your healthcare provider to discuss alternative treatment options.

Overall, if you are concerned about your melasma or have any questions or concerns about your skin, it’s essential to talk to a healthcare provider. They can provide guidance, support, and treatment options to help you manage your condition and maintain healthy, beautiful skin.

FAQs about Melasma  Answered by Your Doctors Online Team

Is melasma a vitamin deficiency?

No, a vitamin shortage is not often the cause of melasma. Although the precise etiology of melasma is unknown, it is thought to result from several variables, including sun exposure, hormone changes, and heredity.

While specific vitamins and nutrients are essential for skin health, no evidence suggests a deficiency in any particular vitamin causes melasma. However, maintaining a healthy and balanced diet that includes a variety of nutrients can help promote overall skin health and may benefit individuals with melasma.

Does melasma go away?

Melasma can sometimes fade away independently, mainly related to hormonal changes (such as during pregnancy) or sun exposure. However, for many people, melasma is a chronic condition that may require ongoing management to maintain the appearance of the skin.

Treatment options for melasma typically involve a combination of topical medications, chemical peels, and laser therapy. It’s essential to work with a healthcare provider to determine the best treatment approach for your case, as the effectiveness of various treatments may vary depending on the underlying cause and severity of your melasma.

Even with treatment, melasma can be a stubborn condition that may require ongoing management. Preventive measures such as sun protection and avoiding known triggers can help minimize the appearance of melasma and prevent a recurrence of the condition.

While melasma can be challenging to manage, it is not harmful and does not typically lead to serious health problems. With proper management and ongoing care, most people with melasma can achieve good results and maintain healthy, beautiful skin.

How to cure melasma from the inside?

Topical drugs, chemical peels, and laser therapy, which act on the skin’s surface, are frequently used to treat melasma. While there is currently no known treatment for melasma, you can take the following actions to maintain healthy skin from the inside:

  • Consume a balanced diet full of fruits, vegetables, and other nutrient-dense foods to maintain a healthy diet: Consuming a nutritious diet can help to promote good skin. Vitamins A, C, and E, zinc, and antioxidants are some nutrients that are very good for skin health.
  • Stay hydrated: Maintaining hydration will help keep your skin healthy and hydrated, which can assist in lessening the look of melasma.
  • Manage stress: Hormonal changes brought on by stress could make melasma worse. Deep breathing exercises, yoga, and other stress-reduction methods may help lower stress levels and improve general health.
  • Consult a healthcare provider: In some cases, underlying medical conditions such as thyroid disorders or certain medications can contribute to the development of melasma. If you are concerned about your melasma or have questions about the underlying cause of your condition, it’s essential to consult a healthcare provider.

Can stress cause melasma?

Indeed, stress can exacerbate or contribute to the development of melasma. Emphasis sets off a physiological reaction that can alter the hormonal balance and boost melanin production, the pigment responsible for the skin’s colour. This can lead to the development of hyperpigmentation, including melasma.

In addition, stress can cause inflammation in the body, further exacerbating skin issues and increasing melasma’s appearance.

It’s important to note that while stress can contribute to melasma, it is usually not the sole cause. Melasma is typically caused by a combination of factors, including sun exposure, hormonal changes, genetics, and certain medications.

Managing stress is essential to maintaining overall health and well-being and may also help reduce the appearance of melasma. Stress-management techniques such as meditation, deep breathing exercises, or yoga can help promote relaxation and reduce the physiological stress response. In addition, seeking support from loved ones or a mental health professional can also be beneficial for managing stress and improving emotional well-being.

Are age spots/sun spots/liver spots melasma?

No, age spots (also known as sun spots or liver spots) are not the same as melasma, although they may look similar. Age spots are typically caused by long-term sun exposure and are more common in people over 50. They usually appear as flat, brown or black spots on the skin, often on areas frequently exposed to the sun, such as the hands, face and arms.

In contrast, melasma is characterized by irregular patches of brown or grayish-brown pigmentation on the face, particularly on the cheeks, forehead, and upper lip. It is more common in women, particularly those pregnant or taking hormonal birth control, and is often triggered by hormonal changes or sun exposure.

While age spots and melasma are different, they can be caused or exacerbated by similar factors such as sun exposure and genetics. Working with a healthcare provider to determine the underlying cause of any pigmentation issues and develop an appropriate treatment plan is essential.

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