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What is melasma?

If you have discoloration or small to large blotchy brown areas on your face, then you may have melasma. The condition occurs suddenly, so it’s not something that builds up over the years (although it may get worse or spread with time) and not something that you would have likely had in your teenage or even early adult years.

It may occur in addition to sun freckles, sun spots or sun damage, or it may occur on its own. Sometimes it’s hard to separate it out from sun freckles and sun damage, but those tend to be small individual separate spots, while melasma tends to be larger blotchy areas.

If you are in the Atlanta or Alpharetta area and would like to discuss treatment options for your melasma, contact Steele Dermatology at (770) 464-6000 or schedule a consultation.

What causes melasma?

There are three causes of melasma: the sun, hormones, and genetic predisposition.

  • The Sun absolutely contributes to melasma. While sun exposure stimulates the pigment-making cells (melanocytes) to make pigment (brown spots, tan, etc.) in all people’s skin, if you have melasma, your melanocytes are extra easily stimulated. Even small amounts of daily sun exposure will excite your melanocytes to make pigment.
  • Hormones are also a huge factor. Sometimes melasma comes during pregnancy, when a woman takes birth control pills, or when a woman starts hormone replacement therapy. Some women will get it outside of these specific times in life, but overall we know that melasma is much, much more common in women. It is likely some women’s natural hormones (Estrogen) contribute to their melasma.
  • Genetics must play some role. Not every woman will get it, even during pregnancy or with hormonal pills, or with lots of sun exposure so there must be some genetic component as well.

Where do you get melasma?

Melasma occurs on the face almost exclusively and more common areas include the cheeks, forehead, and temples. While you can get sun spots and freckles on other areas of the body, it wouldn’t be melasma.

How do we treat melasma?

To remove the pigment for melasma and other conditions, we can use chemical peels, Steele Dermatology (SD) skincare, or laser treatments. Each of these treatments works to remove the extra pigment that is in the affected skin. A vitamin supplement that we recommend also protects the skin from the effects of the sun on your melasma.

Each treatment has its merits and drawbacks. For instance, there are more aggressive peels and lasers that will remove the melasma or pigment, but your recovery (downtime) will be longer. However, you may see faster results. Lighter peels, less aggressive lasers, and at home SD Skin Care regimens will give you results but will take longer to get there. You will have minimal to no recovery time, which may make this an attractive option to some.

No matter how we treat your melasma, you must be diligent about protecting your skin from the sun before and after treatment – think wide-brim hats, sunscreen, sitting in the shade, tinted windows, etc. for severe melasma. Importantly, you will respond and maintain your results best if you discontinue any outside hormones, if at all possible.

chemical peels

Chemical Peels

An in-office application of a specific chemical solution to the skin that causes the top (discolored, pigmented and damaged) layers to peel away a 2-7 days later.

Laser Skin Toning – Laser Genesis

A safe and effective laser treatment to help even skin tone/color and texture for all skin types. A no downtime, “lunchtime” laser treatment that utilizes a unique handpiece to deliver 1064nm wavelength energy.


At home skincare products can be used to slowly and progressively lighten and even skin color. Also, they are essential for maintaining the results of any procedures may do. It will be a combination of cleansers, serums/creams, moisturizers and sunscreen specifically for discoloration or brown spots.

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Schedule an Appointment

With offices conveniently located in Atlanta and Alpharetta, Steele Dermatology offers expert melasma treatments and skincare regimens for our patients. To learn which treatment may be right for you, schedule an appointment or give us a call at (770) 464-6000.