A genetic predisposition is one of the most important risk factors for the development of melasma (Melasma: A Clinical and Epidemiological Review; An Bras Dermatol. 2014). However, no definite clear pattern of inheritance has been identified so far. Most studies in various populations around the world in patients with melasma cite a positive family history and at least one relative with melasma, as high as 97% of first-degree relatives.
However, there are other factors at play too, such as female gender, as you rightly pointed out, hormonal influence, pregnancy, and skin type/colour.
In fact, “acquired” factors play as important a role in the development of melasma. Sun exposure is the most important triggering factor for melasma. Medications such as oral contraceptive pills can trigger it as well. Even the use of some cosmetics may do so.
I would suggest you see a trusted doctor to assess your skin first, as many pigmentary conditions may be mistaken for melasma as well. Even if the diagnosis is indeed melasma, there are options for treatment, ranging from topical medications, oral pills, chemical peels and procedures such as lasers, and your doctor can go through these with you in detail.
Best regards,
Dr. Joanna Chan
