Woman with natural facial pigmentation standing in dappled sunlight

Hormonal Hyperpigmentation: Melasma, Triggers and Care

February 15, 2025

Hormones can influence pigmentation, but “hormonal hyperpigmentation” is not one diagnosis. The best-known example is melasma, which often creates symmetrical brown or gray-brown patches on the face. Pregnancy, hormonal medication, sunlight, genetics and other factors may contribute.

Because several pigment conditions look alike, a changing or persistent patch should be identified correctly before treatment begins.

How Can Hormones Affect Skin Pigmentation?

Melanocytes are cells that produce pigment. In melasma, these cells become more active. The American Academy of Dermatology notes that pregnancy-related increases in estrogen and progesterone are thought to trigger melasma in some people. Hormonal contraceptives and other medications may also be associated with it.

Hormones are rarely the entire story. Sunlight can stimulate more melanin and make patches more visible. Genetics, skin tone and medication may also affect who develops melasma and how long it lasts.

What Does Melasma Look Like?

Melasma commonly appears as flat, symmetrical patches on areas exposed to light, including the cheeks, forehead, nose, upper lip and jawline. It may be brown, gray-brown or darker than the surrounding skin.

A clinician can distinguish melasma from post-inflammatory hyperpigmentation, sun spots, medication-related color change and lesions that need further testing.

Pregnancy and Hyperpigmentation

Melasma that develops during pregnancy is sometimes called the “mask of pregnancy.” It may fade after delivery, but it can also persist. Treatment choices during pregnancy and breastfeeding require extra care, because common skincare ingredients and procedures may not be appropriate.

Ask an obstetric or dermatology professional before beginning an active treatment during pregnancy. Daily sun protection and a gentle routine remain important, but individual guidance should lead product selection.

Can Birth Control Cause Hyperpigmentation?

Hormonal contraceptives are a possible trigger for melasma in some people. Do not stop prescribed contraception without speaking with the clinician who manages it. They can help weigh the benefits, alternatives and likelihood that medication is contributing.

Hormonal Hyperpigmentation Treatment Principles

Sun and visible-light protection

Daily broad-spectrum SPF 30 or higher is central to melasma care. The AAD also recommends considering tinted sunscreen with iron oxides because visible light can contribute to pigment. Reapply as directed and add shade, hats and sunglasses.

A gentle, consistent routine

Products that burn or inflame the skin can make discoloration more noticeable. Introduce one change at a time, support the skin barrier and avoid frequent switching.

Professional treatment when needed

Dermatologists may use prescription topical treatments, chemical peels, devices or combinations selected for the person’s skin and diagnosis. Melasma can recur, so maintenance and trigger management are often part of the plan.

For the broader pigment framework, read What Is Hyperpigmentation? Causes, Types and Treatment Options. If your marks followed acne or irritation rather than a hormonal pattern, see Dark Spots on Face: Causes, Treatments and How to Fade Them.

What Not to Do

Do not stop medication without medical guidance.
Do not use household bleach or unlabeled lightening products.
Do not assume every facial patch is melasma.
Do not combine multiple strong treatments during pregnancy without approval.
Do not rely on permanent-cure claims. Melasma may recur.

When to Seek Medical Advice

See a dermatologist for an uncertain diagnosis, rapidly changing pigmentation, a new irregular spot, symptoms such as bleeding or pain, or discoloration that appears alongside other health changes. Medical advice is particularly important during pregnancy and when medication may be involved.

Frequently Asked Questions

Does hormonal hyperpigmentation go away?

It may improve when a trigger changes, but melasma can persist for years or recur with light exposure and hormonal changes.

Is all pregnancy pigmentation melasma?

No. Pregnancy can be associated with several normal pigment changes. A clinician can assess an unusual, symptomatic or concerning area.

Can a dark spot corrector treat melasma?

Some topical routines may improve its appearance, but melasma is often complex. A dermatologist can confirm the diagnosis and select a plan that fits pregnancy status, skin tone and prior treatment.