Melasma is a common skin condition characterized by brown or brown-grey patches, typically on cheeks. Patients with a family history are more likely to develop melasma than others. Though the exact cause is often unknown, pregnancy, birth control pills, cosmetics, hormones, certain medications and sun exposure often trigger this condition. It usually occurs on the cheeks, forehead and even on the nose. People with dark hair and dark eyes and even dark skin are more prone to melasma because they have more pigment in their skin to begin with. It is caused by a combination of hormones and ultraviolet light. Ultraviolet rays are present even on a cloudy day so it is important to wear a broad-spectrum of minimum SPF 30 sunscreen every day. That is because ultraviolet light reaches the earth's surface and the surface of your skin at all times. If the topical creams do not work then we have peels, other local spot treatments and also laser therapy. A series of laser treatments may be necessary. It usually requires 12 or more treatments two weeks apart. Each patient is unique and requires a different number of treatment sessions. The number of treatments depends on how dark the discoloration is, how deep the pigment is and the natural color of the skin.