Yes, men can get melasma. While the condition is far more common in women, men make up roughly 10 to 25 percent of melasma cases depending on the population studied. The patches look the same, appear in the same places, and respond to the same treatments. Yet male melasma is often underdiagnosed because both patients and clinicians associate the condition almost exclusively with women.
How Common Is Melasma in Men?
The female-to-male ratio for melasma varies widely by country. In Brazil the ratio is as high as 39 to 1, in Singapore 21 to 1, and in India closer to 6 to 1. A study from Puerto Rico found men accounted for about 10 percent of melasma cases, while an Indian study put that number at nearly 26 percent. A Tunisian study of 197 patients found only 5 percent were men. These differences likely reflect genetics, sun exposure patterns, and how willing men in each culture are to seek dermatologic care for cosmetic concerns.
People with medium to darker skin tones (Fitzpatrick types III through V) are most susceptible regardless of sex. That includes people of South Asian, Middle Eastern, Latin American, East Asian, and African descent. The combination of higher baseline melanin activity and intense sun exposure creates the strongest risk profile.
What Causes Melasma in Men?
Sun exposure is the single biggest trigger. Ultraviolet radiation stimulates pigment-producing cells in the skin, and that effect is compounded by heat and visible light. Men who work outdoors, live in tropical climates, or spend significant time in the sun without protection are at elevated risk.
Hormones play a different role in men than in women. In women, estrogen and progesterone fluctuations from pregnancy, birth control, or hormone therapy are well-established triggers. In men, the hormonal link runs through testosterone. An Indonesian case-control study found that men with melasma had dramatically lower average testosterone levels (7.55 nmol/L) compared to men without it (21.07 nmol/L). Men with testosterone levels at or below 8.92 nmol/L had nearly seven times the risk of developing melasma. At normal levels, testosterone appears to suppress the enzyme activity that drives pigment production. When testosterone drops, that braking mechanism weakens.
Genetics also matters. A family history of melasma increases your likelihood of developing it, and certain genetic backgrounds predispose people to more active pigment cells in sun-exposed skin.
Where It Appears on the Face
Melasma in men follows the same three facial patterns seen in women, but the distribution skews differently. The malar pattern, covering the cheeks and nose, is by far the most common in men, affecting 61 to 65 percent of male patients. The centrofacial pattern, which spreads across the forehead, upper lip, nose, and chin, accounts for about 29 to 32 percent. The mandibular pattern, along the jawline, is the least common at under 10 percent.
The patches are typically brown or grayish-brown, flat, and symmetrical. They don’t itch, hurt, or have raised borders. If a darkened patch is only on one side of your face, is raised, or is changing rapidly, it’s more likely something else.
Conditions That Look Similar
Several other types of facial darkening can mimic melasma. Post-inflammatory hyperpigmentation, the dark marks left behind after acne, cuts, or skin irritation, is one of the most common. Age spots (solar lentigines) from cumulative sun damage are another. Freckles that darken with sun exposure can also be confused with early melasma. The key distinguishing feature of melasma is its symmetry and its tendency to worsen with sun exposure and improve when sun is avoided. A dermatologist can use a Wood’s lamp (a type of UV light) to determine whether the excess pigment sits in the upper or deeper layers of skin, which helps guide treatment.
Treatment Options
The first-line approach for melasma combines a skin-lightening agent with a retinoid and sun protection. Hydroquinone at 2 to 4 percent concentration is the most studied topical treatment, with visible improvement typically appearing after 8 to 12 weeks of consistent use. Triple combination creams that pair hydroquinone with a retinoid and a mild steroid are considered the most effective topical option. The retinoid speeds cell turnover, the steroid reduces irritation, and the hydroquinone suppresses pigment production.
Chemical peels can help when topical treatment alone isn’t enough. Glycolic acid peels and mandelic acid peels (10 to 50 percent concentration) are generally the safest choices, particularly for people with darker skin. Mandelic acid has anti-inflammatory properties that make it less likely to cause the redness and rebound darkening that sometimes follow peeling treatments. Deeper peels carry a real risk of scarring and worsening pigmentation in darker skin types, so they’re typically avoided.
Laser treatments exist but require caution. Aggressive laser settings can trigger post-inflammatory hyperpigmentation, essentially trading one pigment problem for another. When lasers are used, lower-energy settings with multiple sessions tend to produce better results than a single high-intensity treatment.
Why Sunscreen Matters More Than Treatment
No treatment for melasma works long-term without rigorous sun protection. Even a few minutes of unprotected sun exposure can undo weeks of progress. Yet men with melasma tend to use sunscreen less consistently than women with the same condition. This is one of the biggest barriers to successful management.
Not all sunscreens are equally effective for melasma. Standard UV-blocking sunscreens help, but products that also block visible light perform significantly better. One study found a 75 percent reduction in melasma severity with a sunscreen blocking both UV and visible light, compared to 60 percent with a UV-only sunscreen. Tinted sunscreens containing iron oxide are the easiest way to get visible light protection, and the tint itself helps camouflage the patches. For men who feel uncomfortable with a visibly tinted product, many formulations now dry down to a neutral, matte finish that’s essentially invisible.
Beyond sunscreen, wearing a wide-brimmed hat and avoiding peak sun hours (roughly 10 a.m. to 2 p.m.) make a meaningful difference. Heat itself, independent of UV light, can worsen melasma, so saunas, steam rooms, and prolonged exercise in direct sun are worth being mindful of.
Long-Term Outlook
Melasma is a chronic condition. It can be controlled, sometimes to the point where patches are barely visible, but it tends to return with sun exposure, hormonal changes, or lapses in treatment. For men whose melasma may be driven by low testosterone, addressing the underlying hormonal issue could improve outcomes, though research on this approach is still limited. The most reliable long-term strategy is a combination of maintenance topical treatment and consistent sun protection, treating melasma less like a one-time problem to solve and more like an ongoing skin condition to manage.