Hyperpigmentation and melasma

Hyperpigmentation means patches of skin that are darker than the skin around them. Two common forms are melasma and post-inflammatory hyperpigmentation, and both are more frequent in darker skin.

Melasma

Melasma shows up as tan, brown or greyish patches, usually on the face. During pregnancy it is sometimes called "the mask of pregnancy". It mostly affects women, and people of African, Asian or Hispanic descent with Fitzpatrick types III and above are at higher risk, especially where the sun is strong.

Treatment

Evidence favours combining treatments over relying on one. Options used by dermatologists include hydroquinone, tretinoin, azelaic acid and tranexamic acid, as well as chemical peels and lasers. Strict sun protection, with broad-spectrum sunscreens based on zinc oxide or titanium dioxide, underpins all of them; see sun protection.