Q: I've never been pregnant, but I have dark splotches—Melasma, "the mask of pregnancy"—on my cheeks and upper lip. What causes this and how can I get rid of it?
A: You don't have to be pregnant to get melasma, which can be caused by hormones (often pregnancy related) or by prolonged or excessive sun exposure, says Tina Alster, MD, clinical professor of dermatology at Georgetown University Medical Center. To treat it at home, look for creams that contain kojic acid or Melaplex (Alster recommends Neocutis Perle, $95; DermaDoctor.com). Alster prefers products that don't contain skin-lightening hydroquinone (which is potentially irritating). In the doctor's office, a chemical peel can help, but be careful about laser treatments (they've been associated with pigment recurrence or worsening of the mask). The Fraxel Re:store Dual laser looks promising, because it targets surface pigment and limits inflammation; be sure the treatment is delivered by a doctor who has experience using it.

Keep in mind: One of the most critical steps you can take to reduce your chances of getting melasma is to stay out of the sun.

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From the January 2011 issue of O, The Oprah Magazine

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