What should you know about extrafacial melasma?

Patches may appear on the forearms, hands, neck or other exposed areas as tan, brown or grey-brown uneven colour. Melasma involves increased pigment production and can be influenced by light exposure, hormonal changes, heat and skin irritation. Pigmentation outside the face can resemble sun-damaged skin or another pigment disorder, so an examination is useful.

The depth and pattern of pigment affect how it responds to treatment. A clinician may review medicines, pregnancy or hormonal factors, previous inflammation and daily exposure before recommending a plan.

Use shade, protective clothing and broad-spectrum sunscreen on exposed skin. Reapply as directed during outdoor activity, and reduce avoidable heat or friction. Choose gentle, fragrance-free products and stop any product that causes stinging or a rash.

A dermatologist may consider a topical lightening plan or procedures such as a chemical peel, microneedling or laser toning. These can irritate skin and sometimes make pigmentation more noticeable, so treatment settings and aftercare should be tailored to your skin tone and diagnosis.

Arrange a medical review for new, spreading or unexplained dark patches, especially if a patch is itchy, scaly, painful, bleeding or changing in shape. Seek care sooner when pigmentation follows a medication change or a significant rash, because treating the underlying inflammation may be part of the plan.

Ask whether the pattern fits melasma, whether another pigment condition should be excluded, which exposures may be maintaining it, and how long to trial each treatment before changing course.