Melasma typically appears as dark hyper-pigmented patches on sun exposed areas of the skin, most commonly on the face. The most common areas affected are the frontal forehead and malar cheeks. 90% of people affected are female, 10% male. It is commonly associated with the use of oral contraceptives (Birth control pills) but can occur naturally, especially in darker skinned individuals.
Melasma can also occur during pregnancy, as hormonal fluctuations occur. Sun exposure can worsen the condition, so daily sunscreen is recommended for maintenance and control of Melasma. There are prescription strength topical creams used to treat Melasma, including Tretinoin (Retin-A, Renova) and Hydroquinone. Some medications combine these components along with a topical steroid (Triluma).