Melasma is a common pigmentation disorder that causes brown or gray spots to appear on the skin, especially on the face. The most common areas for melasma to appear on the face include the bridge of the nose, the forehead, the front of the head, the cheeks and the upper lip. Also, melasma may appear in other areas of the body, especially those that are exposed to a lot of sunlight, such as: forearms, neck, and shoulders. Women are more likely to suffer from melasma than men, as studies show that only 10% of all cases of melasma occur in men. Dark-skinned women who are pregnant are more likely to develop melasma. The exact cause of melasma is not known, but it is likely that it occurs due to a defect in the melanocytes that give the skin its natural color, which causes the production of excessive amounts of skin pigment. Melasma triggers include: Hormonal changes during pregnancyOr hormone therapy or birth control pills, exposure to the sun, and the use of certain skin care products that cause skin irritation. It is worth saying that melasma may be hereditary, as people who have close relatives with melasma are more likely than others to develop melasma. 
Melasma can be prevented by avoiding direct exposure to sunlight by wearing hats and using a sunscreen that has a sun protection factor (SPF) of at least 50, and contains physical blockers, such as: zinc oxide. And titanium dioxide, to prevent ultraviolet rays, and not to rely on sunscreens that contain chemical blockers only because they do not block both A and B ultraviolet rays sufficiently. Sunscreen should be used daily when leaving the house To enhance the effectiveness of treatments for melasma and reduce further development of spots. 
Melasma resulting from pregnancy or using the contraceptive pill can disappear automatically after childbirth or stop using the pill. However, for some people, melasma may last for several years or for a lifetime. In cases where the melasma does not disappear on its own, melasma can be treated through several methods , and it should be noted that the treatment of melasma under the care of a dermatologist may take a few months to see improvement, as melasma may be stubborn and not disappear easily. . It should also be noted that the treatment may continue for a period after eliminating the melasma to prevent the recurrence of the melasma again. To ensure that treatment does not fail, people should reduce exposure to sunlight, and pregnant or breastfeeding mothers should not treat melasma without consulting a doctor due to the potential risks of the drugs on the development of the fetus and newborn. It includes methods of treating melasmaThe following:  
- Hydroquinone: Hydroquinone is the # 1 treatment for melasma. It comes in several pharmaceutical forms, including: cream, lotion, and gel. This drug is applied topically to the skin to lighten the skin. It is available in concentrations as low as 2%, and higher concentrations up to 4%, and it is reported that a higher concentration is associated with a greater risk of skin irritation than a lower concentration. Hydroquinone should be applied to the spots of melasma twice daily, with the need to apply sunscreen over the hydroquinone in the morning. Potential side effects of melasma treatments include: temporary skin irritation, and people who use hydroquinone therapy in very high concentrations for prolonged periods ranging from several months to years are at risk of developing a side effect called exogenous polyposis ; It is a permanent change in the color of the skin during the use of hydroquinone, and it is more common if high concentrations of hydroquinone exceeding 4% are used.
- Tretinoin and corticosteroids: These drugs help to increase the effectiveness of skin lightening treatments, examples of which are: Retinoic acid at a concentration of 0.025-0.1%, Tazarotene at a concentration of 0.05-0.1%, and Adapalene at a concentration 0.1-0.3%
- Other topical medications: A dermatologist may prescribe Azelaic acid at a concentration of 15-20%, or Kojic acid , lactic acid lotion at a concentration of 12%, and creams of glycolic acid at a concentration 10-20%, and a high concentrated glycolic acid scrub to help reduce melasma.
If the previously mentioned medicines do not treat melasma, the doctor may resort to other methods of treatment. It should be said that there is no guarantee that these measures will be effective in getting rid of freckles, or reducing the stains resulting from it, and it should be said that very harsh treatments or abrasive treatments can cause or increase the symptoms of melasma. Other treatments for melasma include many procedures such as: chemical peels, skin scraping, or laser treatment, and the following are a list of those procedures : 
- Chemical peels: , the treatment costs under the supervision of the chemical peeling the doctor through the use of chemicals such as peeling Glicolak acid concentrations ranging from 30-70%, or through the use of different combinations , such as: the combination of 10% of the acid Glycolic and 2% hydroquinone.
- Superficial peeling: , during this procedure, the skin is peeled and regenerated using soft crystals such as: fine diamond chips or aluminum oxide crystals, in addition to the use of a vacuum pump. The treatment is done in the form of several sessions lasting from a few minutes to one hour. It should be noted that the patient should also use sunscreen and other creams to get the best results.
- Laser therapy: can be used as a laser to treat the costs , but the results are temporary in the habit, where studies have shown that the laser does not reduce hyper - pigmentation of the skin as it may increase the symptoms of some types of costs, so should consult a doctor before using the laser treatment for cost. The use of lasers to treat melasma may require several sessions before seeing the expected results.
- ↑ "What is melasma" , www.medicalnewstoday.com , Retrieved 10-1-2019. Edited.
- ^ A b t "Melasma" , Www.medicinenet.com , Retrieved 10-1-2019. Edited.
- ↑ “MELASMA: DIAGNOSIS AND TREATMENT” , www.aad.org , Retrieved 10-1-2019. Edited.