Melasma is a common facial skin pigment problem with patches of excessively dark skin. Most people with melasma are women, but men also suffer from it too, especially those with darker skin. The disfiguring facial hyperpigmentation of melasma can be emotionally devastating. It can even cause social isolation.

What causes Melasma to happen?

The cause of melasma is complex and not fully understood. We do know that melanocyte cells (the skin’s pigment-producing cells) are stimulated by a number of different things including UV light, but the pigment formed with melasma is not the same as a tan. It is much more complex.

In melasma, there is a cascade of events that happen from UV exposure and visible light, such as from indoor lighting. Yes, indoor (visible) light can also play a role in causing melasma!

The problem of melasma is more than just a problem of excess pigment, it includes what happens to the pigment and the skin around the pigment.

  • Light causes melanin to be formed and cells called melanophages to gobble up the melanin and hold it in both the epidermis and dermis.
  • In the skin where melasma exists, there is also evidence of sun damage in the dermis (changes in elastic fibers).
  • There are also more blood vessels in the skin where melasma pigment exists!
  • Immune cells and dermal fibroblasts are also more active and playing some role in causing melasma.
  • Melasma is a very complex physiologic process that can even sting and itch.
  • Genetics also play a role in whether you are predisposed to melasma.