Chloasma is a form of hyperpigmentation that causes patches or spots on the skin — usually the face — that are darker than the surrounding skin. Sun protection, topical medications, and skin procedures can help to treat chloasma.

“Chloasma gravidarum” is another term for melasma. Chloasma can occur with pregnancy, sun exposure, thyroid disease, birth control pills, or other medications. Genetics can also play a role in who develops chloasma.

This article looks at the symptoms, causes, diagnosis, treatment, and outlook for chloasma.

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Chloasma is more common in females than males, with the condition affecting females 9 times more than males.

Chloasma can affect people of any race and ethnicity. It is more common in people with darker skin, particularly in people with light brown skin, compared with people with lighter skin.

Chloasma does not usually occur before puberty. It more commonly affects people in their reproductive years.

Exposure to ultraviolet (UV) light, through sunlight or tanning beds, is the most significant cause of chloasma. Exposure to UV light increases melanin production, which creates skin pigmentation. Excess melanin production can cause the dark patches characteristic of chloasma.

Other factors that may contribute to chloasma include:

  • Genetics: Genetics can predispose some people to chloasma more than others.
  • Hormones: Estrogen and progesterone may play a role in chloasma.
  • Thyroid disease: Research has found an increase in thyroid disease in people with chloasma.

Certain medications may trigger chloasma, including:

What causes chloasma in pregnancy?

Although the exact cause of chloasma in pregnancy is unclear, it may be due to increased levels of certain hormones.

Estrogen, progesterone, and melanocyte-stimulating hormone generally increase during the third trimester of pregnancy, which may cause chloasma.

Chloasma usually affects areas of the face that have frequent sun exposure, including the:

  • cheeks
  • forehead
  • chin
  • nose
  • area above the upper lip

In some cases, people may develop chloasma on other areas of the body, such as the jaw, neck, or arms.

Chloasma appears in symmetrical patches or spots that may be brown, gray, or darker than the surrounding skin tone. Chloasma does not cause any change in sensation to the skin, such as pain or itching.

To diagnose chloasma, a doctor or dermatologist will examine the face or any affected areas. A doctor may use specialized devices to examine the skin, such as:

  • a dermatoscope, which uses a light and magnifying glass to see the skin in more detail
  • Wood’s lamp, which uses UV light to show areas of hyperpigmentation

These devices can help a doctor see deeper into the layers of skin to assess the extent of chloasma.

In some cases, a doctor may take a small skin sample to examine under a microscope. This can help them rule out other skin conditions that may appear similar.

If a doctor suspects a thyroid issue, they may carry out thyroid function tests.

Chloasma does not cause any harm to the body, but people may want to treat it for aesthetic reasons.

According to a 2018 review, treatment for chloasma may include the following:

  • protecting the skin from sunlight and avoiding triggers to suppress the activity of the cells that produce melanin
  • using depigmenting agents to suppress melanin production
  • removing or scattering excess melanin from the skin through treatments such as chemical peels and laser therapy

Sun protection

Sun protection is important in treating chloasma and can help to fade chloasma as well as prevent it from recurring. Sun protection includes:

  • wearing sunscreen of at least 30 SPF every day, which protects against both UVA and UVB light
  • wearing a wide-brimmed hat
  • staying in the shade during peak sunlight

Topical medication

A doctor may prescribe a topical medication to even out the skin tone, such as:

  • hydroquinone
  • a combination of tretinoin, which is a retinoid, and a mild corticosteroid, which is an anti-inflammatory drug
  • a combination cream containing tretinoin, hydroquinone, and a corticosteroid
  • medications containing vitamin C, azelaic acid, or kojic acid

Cosmetic procedures

The following procedures may also help to treat chloasma:

  • Chemical peel: This helps remove the areas of hyperpigmentation.
  • Microneedling: This creates controlled skin damage so it evens out skin tone when it heals.
  • Laser or light therapy: This may help reduce chloasma alongside topical medications and sun protection.
  • Platelet-rich plasma: This involves taking a sample of a person’s own blood, extracting the plasma, and then injecting the plasma into the skin to even out skin tone.

According to the American Academy of Dermatology (AAD), chloasma may resolve by itself.

If pregnancy or a certain medication is causing chloasma, it may go away after childbirth or after stopping the medication. The AAD also notes that chloasma can last for years or sometimes a lifetime.

Chloasma is not harmful to the body, and researchers have found no link between chloasma and skin cancer.

Protecting the skin from sunlight and avoiding triggers is important and may help reduce the risk of chloasma persisting or recurring.

According to a 2018 review, triple-combination topical medication is the gold standard for treating chloasma.

The most effective treatment is generally a combination of sun protection with topical medications. Skin procedures may also help to improve results.

What is the difference between chloasma and melasma?

Chloasma, or chloasma gravidarum, is another term for melasma. People may also refer to it as the “mask of pregnancy,” as it can occur with pregnancy.

Is melasma caused by too much estrogen?

Hormones can play a part in melasma, although experts are still unclear on the exact link.

Increased levels of estrogen, progesterone, and melanocyte-stimulating hormone (MSH) during pregnancy may cause melasma.

However, people who have not given birth and develop melasma do not have higher levels of estrogen or MSH, but the areas of melasma do have higher levels of estrogen receptors.

Oral contraceptives containing estrogen and progesterone may also link to melasma, as well as diethylstilbestrol, which is a synthetic form of estrogen.

People who take progesterone postmenopause may develop melasma, while those who take estrogen-only medication do not. This suggests progesterone plays a key role in the formation of melasma.

Chloasma, or melasma, is hyperpigmentation that typically appears on the face. It causes spots or patches of skin that are darker than a person’s natural skin tone.

Chloasma may link to hormones and can occur with pregnancy or oral contraceptive use. Sunlight exposure, certain medications, and thyroid disease may also cause chloasma.

Treatments for chloasma aim to fade the hyperpigmentation and include sun protection, topical medications, and skin procedures.