Dark pigmentation on the face is a classic symptom of melasma, a common skin disorder characterized by excessive production of melanocytes, the specialized cells that give your skin pigment, or color. The condition most frequently affects women in their thirties who tan easily or have relatively dark natural skin pigmentation.
The Basics
Melasma most commonly appears on your forehead, upper lip or cheeks, where it produces large blotches of discoloration or smaller patches similar to freckles, according to the New Zealand Dermatological Society. Discoloration may also occur on the sides of your neck, as well as on your upper arms or shoulders. Depending on your circumstances, the pigment changes associated with melasma may appear in the outer layer of your skin, called the epidermis, or in the deeper layer called the dermis. In some cases, you may develop melasma-related discoloration in both of these skin layers.
Melasma Factors
The precise causes of melasma are unknown, according to the American Academy of Dermatology, or AAD. However, the condition has a genetic element, and you have a greater chance of developing discoloration if it runs in your family. The New Zealand Dermatological Society lists potential triggers for a melasma outbreak that include sun exposure, use of hormone-based contraceptives, pregnancy and use of cosmetics, toiletries or soaps that contain scents or deodorants. When it occurs during pregnancy, melasma is commonly known as chloasma. In some cases, melasma symptoms develop in individuals with no known triggers or stressors.
Treatment
If you develop melasma, your doctor may prescribe any one of a number of creams that promote skin lightening, the AAD reports. Potential active ingredients in these creams include hydroquinone, glycolic acid, tretinoin, kojic acid, azelaic acid and corticosteroids. In some circumstances, your doctor may treat melasma with a procedure designed to remove the layer of skin that contains excessive pigmentation; examples of these procedures include microdermabrasion, laser surgery and chemical peels. If you develop melasma while pregnant, your symptoms may resolve when your pregnancy ends. Similarly, melasma caused by birth control may resolve if you stop using birth control products. Melasma also fades spontaneously in some individuals.
Sunscreen
You may be able to prevent melasma symptoms by using sunscreen and avoiding sunlight when possible, according to the U.S. National Library of Medicine's Medline Plus. If you have melasma, or have a family history of the condition, even brief exposure to sunlight can increase skin discoloration. The AAD recommends products with a minimal sun protection factor of 30 that also provide protection from both ultraviolet A and ultraviolet B light. Potential active ingredients in these products include titanium oxide and zinc oxide.
Additional Causes
You may develop abnormal facial pigmentation for reasons not related to melasma, according to the Merck Manuals Online Medical Library. For example, use of medications such as minocycline and antimalarial drugs can produce bluish or grayish discoloration. Exposure to the heavy metal bismuth can also produce blue or gray discoloration, and exposure to silver can produce a gray discoloration on any part of your body exposed to sunlight.
