Every year around the summer solstice, our schedule fills with the same concern: blotchy brown patches across the cheeks, forehead, or upper lip that seemed faint in winter and have suddenly deepened. If that sounds familiar, you're likely dealing with melasma — one of the most common pigment conditions we see, and one that Southern Oregon's long, bright summers reliably bring to the surface.
Melasma is a chronic condition in which the skin produces excess pigment in symmetrical patches, most often on the face. It tends to appear in shades of tan to grey-brown and favors the cheeks, bridge of the nose, forehead, and the area above the lip. It is more common in women and in people with medium to deeper skin tones, though anyone can develop it.
The pigment cells in melasma-prone skin are essentially over-reactive. Once they've been switched on, relatively small triggers can keep them producing extra color. That's why melasma is best thought of as a condition to manage steadily over time rather than a stain to scrub away in a single visit.
Three triggers drive most melasma, and summer turns all three up at once. The biggest is ultraviolet light. Both UVA and UVB stimulate pigment production, and our region's high number of clear summer days — plus the extra UV that comes with our elevation and outdoor habits like rafting, gardening, and time on the lakes — gives those over-active cells constant encouragement.
Visible light and heat matter too. Recent dermatology research has shown that visible light, including the high-energy light from bright sun and screens, can worsen melasma in deeper skin tones, and that heat alone can stimulate pigment. The hot, dry valley afternoons we're known for aren't just uncomfortable; they're part of the picture. Hormonal shifts from pregnancy or oral contraceptives are the third major trigger, which is why melasma is sometimes called "the mask of pregnancy."
Effective melasma care is layered and patient, and it always starts with protection. We ask patients to use a broad-spectrum, tinted mineral sunscreen with SPF 30 or higher every day — the iron oxides in tinted formulas help block visible light that clear sunscreens miss — and to reapply during outdoor activity. A wide-brimmed hat does more than most products on the shelf.
From there, your provider may recommend prescription-grade topical regimens to gently slow pigment production, along with medical skincare lines we carry in clinic such as skinbetter science, Hydrinity, and Colorescience, chosen to match your skin and tolerance. For some patients, a carefully selected in-office treatment like a gentle chemical peel can help — but only when timed and dosed conservatively. Aggressive lasers and heat-based devices can actually worsen melasma if used too early or too strongly, so we're deliberately cautious and often save energy-based options for the lower-sun months of fall and winter.
Melasma improves gradually, and realistic expectations are part of the treatment. Most patients see meaningful lightening over a few months of consistent care, with the understanding that flares can return with sun, heat, or hormonal changes. The goal is steady control and a plan you can maintain year-round — not a quick fix that risks rebound.
If your brown patches have darkened this summer, the most useful first step is an evaluation to confirm it's melasma rather than sun spots, freckling, or another pigment issue, since each is treated differently. Mariana D. Cooper, PA-C, and Abby Coats, PA-C, can build a plan suited to your skin and your schedule.