Typical Facial Melasma

Description

Centered on the malar cheeks and nasal dorsum, irregular macular hyperpigmented patches extend laterally toward the zygomatic eminences and superiorly toward the lower forehead, with softer borders that blend into adjacent facial skin. Fainter pigmentation may be appreciated along the upper cutaneous lip and mandibular body, respecting the vermilion border and sparing the periorbital skin. Surface scale and papules are absent, and the lesion remains flat, a key point when you are separating melasma from inflammatory dermatoses. Flat. Brown-gray. Melasma in an adult man is less common than in women, so this presentation often prompts a careful trigger and medication history, including chronic ultraviolet exposure, photosensitizing agents, topical fragrance products, and prior irritation from cosmetic procedures or retinoids. The distribution over the centrofacial and malar regions aligns with typical melasma patterns, while the lack of telangiectasia, persistent erythema, and papulopustules helps distinguish it from rosacea or steroid-induced facial dermatitis in a similar anatomic zone. For teaching, it also supports discussion of epidermal versus dermal pigment components, what a Wood lamp can and cannot clarify, and why treatment plans often combine strict photoprotection (visible light included) with topical agents such as hydroquinone, azelaic acid, or tranexamic acid, while setting expectations about recurrence. Dermatology lectures, primary care training modules, and patient-facing counseling materials on hyperpigmentation will benefit from this straightforward clinical rendering, including side-by-side comparisons with post-inflammatory hyperpigmentation and photoaging. Editorial use fits chapters on facial pigmentary disorders, cosmetic dermatology consult workflows, and differential diagnosis of facial patches in men. Anatomical accuracy verified by SciePro's Medical Advisory Board.