Melasma is also known as cholasma and appears as a blotchy, brownish pigmentation on the face that develops slowly and that can fade with time. The pigmentation is due to overproduction of melanin by the pigment cells, melanocytes.
Melasma/Cholasma usually affects women; only one in twenty affected individuals are male.
It is thought to be primarily related to external sun exposure, external hormones like birth control pills, and internal hormonal changes as seen in pregnancy. It is more common in people that tan well or have naturally dark skin compared with those who have fair skin.
Melasma affects the forehead, cheeks and upper lips resulting in macules (freckle-like spots) and larger patches. Occasionally it spreads to involve the sides of the neck, and a similar condition may affect the shoulders and upper arms.
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