Melasma is a common disorder where there is increased pigmentation of the skin, usually of the sun exposed areas of the face. It is most common in women with darker skin tones and women who are on birth control pills, taking hormone replacement, or pregnant. The exact causes are unknown, but there are genetic factors at work and melasma is made worse by exposure to sunlight. Melasma is difficult to treat and returns easily, especially after exposure to sunlight. It is very important for people with melasma to use sunscreen and avoid sun exposure as much as possible. Prescription creams are helpful in treating melasma, as are chemical peels. Laser treatments also help improve melasma, however certain types of lasers may make melasma worse. It is important to seek treatment from a board-certified dermatologist who has experience with lasers to be sure that you are being treated the right way.