Melasma is a pigmentation which occurs on the skin. It is linked to hormones, heat, as well as chronic sun exposure.  Occasionally melasma will occur at the time of pregnancy and then disappear spontaneously. More commonly, however, the pigmentation remains and can be a great cosmetic concern. Treatments include fading creams such as hydroquinone as well as a combination of facial peels and aggressive sun  and heat protection. Sand Lake Dermatology also offers new treatment options including topical cysteamine (Cyspera) and oral tranexamic acid for those who are candidates.