Melasma is a very common condition affecting middle-aged people. Melasma occurs between the age of 20 and 40 years. It is more commonly seen in females than in males. It is a skin problem that can lead to considerable embarrassment and distress.

Melasma is a chronic skin disorder that results in symmetrical, brownish patches on the face, mainly affecting the cheeks, nose, forehead, and upper lip area. It is also called the mask of pregnancy as it is common in women during and post-pregnancy.

Melasma is a complex skin condition with many causes that leads to its pigmentation. There is evidence of a strong genetic predisposition to melasma. One in every three people reports a positive family history. It commonly arises in healthy adults. Chronic sun exposure leads to increased deposition of melanin pigment within the dermis, which persists for long-term. Exposure to ultraviolet radiation (UVR) worsens pigmentation because it activates the melanocyte cells in the skin to produce more melanin.

It presents as irregular, light to dark brown skin-colored patches present on both sides of the face. The most common area to be affected includes the malar area (cheeks), followed by the nose, forehead, and upper lip. It might be also associated with prominent vessels in the background.

It is usually very slow to respond to treatment, especially if it has been present for a long duration. It is a very difficult condition to treat. A single treatment is rarely helpful in getting rid of melasma.