Alerts and Notices
SynopsisMelasma is an acquired disorder of hyperpigmentation typically affecting sun-exposed areas of the face. The condition is more common in women with darker skin phototypes (including those of Hispanic and Asian descent). Melasma rarely occurs before puberty, with onset most often in the reproductive years. It has also been rarely reported in males.
Melasma is characterized by irregularly bordered, evenly pigmented tan macules on the face. Darker macules may sometimes be seen ("dermal melasma"). Although the pathophysiology of melasma is poorly understood, thyroid autoimmunity, ultraviolet radiation, hyperestrogenism (pregnancy, contraception), genetics, and anti-epileptic medications are known to be contributing factors.
L81.1 – Chloasma
36209000 – Melasma
Differential Diagnosis & Pitfalls
- Post-inflammatory pigmentation from acne, eczema, superficial injuries
- Drug-induced hyperpigmentation from medications such as tetracyclines, phenothiazines, minocycline, and amiodarone (usually more diffuse and less irregular in morphology compared with melasma)
- Poikiloderma of Civatte (usually involves neck)
- Hydroquinone-induced exogenous ochronosis, also typically seen in darker skin phototypes
- Acquired dermal melanocytosis
- Nevus of Ota
- Erythromelanosis colli et faciei
- Riehl melanosis
- Facial erythema ab igne (seen in silversmiths, jewelers, bakers, chefs)
- Lentigo maligna
- Lentigo maligna melanoma
- Erythema dyschromicum perstans
- Addison disease
- Fixed drug eruption
- Use of mercury-containing creams
Drug Reaction DataBelow is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
Patient Information for Melasma