How to Identify & Treat a Melasma Mustache

Melasma is a common skin condition that causes light- to dark-brown patches and/or freckle-like spots on the skin, especially the face. In people with darker skin tones, melasma may appear blue-gray. When it develops on the skin above the upper lip, it is known as a “melasma mustache.” Melasma is much more common in women, though men can get it, too.

Learn more about melasma mustache causes, diagnosis, and treatments.

What Causes a Melasma Mustache?

The exact cause of melasma mustache is not fully understood, but some research suggests that the skin cells that produce melanin, called melanocytes, may be more active in people with the condition. Certain triggers may cause these cells to go into overdrive, leading to melasma.

Factors that may cause melasma mustache include:

• Sun exposure and/or exposure to ultraviolet (UV) rays from tanning beds
• Pregnancy 
• Genetics
• Certain medications (e.g., hormonal birth control, anti-seizure medications)
• Thyroid disease 

What Does a Melasma Mustache Look Like?

Melasma mustache may appear as light brown, dark brown, or blue-gray patches or spots on the skin above your upper lip. The spots are often symmetrical and may form under your nostrils or on the entire upper lip area, giving it a shadowy, darkened, or mustache-like appearance.

How to Treat a Melasma Mustache

If a melasma mustache appears during pregnancy or while taking certain medications (e.g., hormonal birth control), it may disappear once you give birth or stop taking the drugs. Though melasma mustache does not require treatment, many people prefer to reduce or eliminate the appearance of dark patches and spots to boost their self-confidence. 

The following are treatments for melasma mustache.

Topical Creams

Topical treatments (applied directly to the skin) are the first-line therapies for treating melasma. Hydroquinone, a skin-lightening cream, is highly effective. Hydroquinone may be combined with other ingredients, such as:

• Tretinoin
• Fluocinolone acetonide 
• Iron oxide
• Azelaic acid 
• Kojic acid
• Ascorbic acid (Vitamin C)
• Corticosteroids

Chemical Skin Peels

A chemical solution is applied to the skin to destroy and peel away the hyperpigmented (darker skin) top layers so that new, healthier-looking skin can grow in its place. Most chemical peels for melasma contain an acid-based compound—glycolic or salicylic acid—along with a small amount of trichloroacetic acid. Peels may be performed monthly or biweekly, depending on their concentration.

Laser Skin Lightening

Using a focused beam of light energy, laser skin lightening targets chromophores (e.g., melanin) to lighten dark patches on the skin. Low energy levels and short pulse durations are most often used to treat melasma mustache to reduce damage to the surrounding tissues. Even when a conservative approach is taken, there is a risk of the dark spots worsening with laser treatment. 

Micro-Needling

Tiny needles are used to create small punctures in the skin to place topical melasma creams more deeply and evenly into the epidermis (top layer of skin) and dermis (middle layer of skin) to reduce dark patches and spots. 

Oral Therapies

Tranexamic acid (a synthetic version of lysine) taken orally slows down melanin production and may be prescribed with topical or laser treatments. Daily doses of the medication over a short period (eight to 12 weeks) may decrease melasma mustache patches.

Other Symptoms of Melasma

Melasma mustache does not cause other symptoms apart from the blotchy patches or spots on the upper lip that are slightly darker than your natural skin tone. You may notice it more after you’ve spent time in the sun. Melasma only appears on parts of the body exposed to the sun, including:

• Cheeks
• Chin
• Forearms
• Forehead
• Neck
• Nose

Melasma mustache may cause emotional distress since it affects appearance. Studies show that melasma can profoundly affect a person’s psychological well-being and negatively impact self-esteem.

Diagnosis

A dermatologist can diagnose melasma by looking closely at your skin. They may use a special device called a Wood’s lamp to get a closer look and identify how deeply the darker pigmentation goes into the layers of skin.

Melasma can sometimes look like other skin pigmentation conditions, so your healthcare provider may perform a biopsy to provide an accurate diagnosis. A skin biopsy is a procedure that removes a small sample of skin. The sample is sent to a laboratory, where it is examined under a microscope to check for skin infections, skin cancer, and skin disorders (e.g., vitiligo).

Summary

Melasma mustache is a common skin condition that causes light brown, dark brown, or blue-gray patches or spots on the skin above the upper lip. The patches or spots may be shadowy or dark, giving a mustache-like appearance.

Women are most likely to develop a melasma mustache, particularly those who are pregnant, taking certain medications, and/or have light- to medium-brown skin color. Treatments include topical creams to lighten the skin, laser treatment, micro-needling, and oral medications. 

A Word From Verywell

While a melasma mustache is not harmful, you may feel self-conscious about your appearance with a dark upper lip. A dermatologist may recommend treatments, such as topical creams, to help reduce melasma patches. Wearing a sunscreen with a high sun protection factor (SPF) can help protect against sun damage and reduce the risk of melasma mustache worsening or reappearing after treatment.