Sanaa Lathan has captivated audiences for years with her performances in films like Love & Basketball, The Best Man and Brown Sugar. But in a TikTok video shared by the actress, she also brings attention to a skin condition that many women may recognize: melasma.
Melasma causes darker patches to appear on the skin, usually on the face. It is especially common among women with medium to deep skin tones, including Black women.
For some, the patches may come and go. For others, they can last for years. And while melasma is harmless, it can affect confidence—especially when the discoloration doesn’t seem to respond to the latest skincare product.
Here’s what to know about melasma, how it’s treated and other skin concerns Black women may experience after 40.
Melasma is a skin condition that causes patches or spots darker than a person’s natural skin tone. It most often appears on the face, particularly on the:
The patches may look tan, brown, grayish brown or bluish gray, depending on your skin tone and how deep the pigment is. Melasma often appears on both sides of the face, though it can also develop on other sun-exposed areas, such as the neck and arms.
Melasma is not contagious, cancerous or physically harmful. But that doesn’t mean its emotional impact should be dismissed. Changes in appearance can affect how people feel about their skin and themselves. www.aad.org
There isn’t one single cause of melasma. Researchers believe several factors can contribute, including:
Melasma is sometimes called the “mask of pregnancy” because it can appear during pregnancy. But you don’t have to be pregnant—or have ever been pregnant—to experience it.
Although anyone can develop melasma, it is much more common in women than in men. Women with medium to darker skin tones are especially likely to experience it, including women of Black, Latina, Asian and Native American heritage.
Melasma often first appears between ages 20 and 40, but it can persist or develop later in life. A family history of melasma, hormonal changes and sun exposure can all play a role.
Before trying to fade a dark patch, it’s important to know what’s causing it. A dermatologist can determine whether you have melasma or another condition and recommend a plan for your skin.
There is no permanent cure that works for everyone, but treatment can help fade discoloration. Melasma can also return, so ongoing care may be needed.
Sunscreen is one of the most important steps in managing melasma—even if you have a deep skin tone.
The American Academy of Dermatology recommends a broad-spectrum sunscreen with SPF 30 or higher. A tinted sunscreen containing iron oxide can be particularly helpful for melasma because it also protects against visible light, which can contribute to pigmentation.
Apply sunscreen daily, reapply according to the label when outdoors, and consider a wide-brimmed hat and shade for additional protection.
Depending on your skin and the severity of the melasma, a dermatologist may recommend:
These products should be chosen carefully. Irritation can make discoloration worse, especially in darker skin tones. Use hydroquinone and steroid-containing products under a clinician’s direction.
A dermatologist may recommend a chemical peel, microneedling, or a laser or light treatment for some patients. These are generally considered alongside sun protection and topical treatment.
Because procedures can cause irritation and additional pigmentation, choose a board-certified dermatologist experienced in treating skin of color.
When melasma is especially difficult to treat, a dermatologist may discuss tranexamic acid, which may be applied to the skin or prescribed as a pill for selected patients.
Oral tranexamic acid is not right for everyone. A clinician will review your health history, including any history of blood clots, before prescribing it.
Patience matters: According to the American Academy of Dermatology, treatment can take three to 12 months to show results. If you are pregnant or breastfeeding, talk with your healthcare professional before using melasma treatments.
Melasma isn’t the only skin concern that can become noticeable in midlife. There isn’t a definitive ranking specifically for Black women over 40, but these are common concerns worth knowing about.
Have you ever watched a pimple disappear, only to be left with a dark mark? That discoloration is often post-inflammatory hyperpigmentation, or PIH.
It can follow acne, eczema, insect bites, burns, cuts or irritation from skincare products. These dark spots are a common reason people with deeper skin tones visit a dermatologist.
The first step is treating whatever caused the inflammation. If acne or eczema keeps flaring, new spots can continue to appear. Sun protection and dermatologist-recommended treatments may help existing marks fade, although it can take months.
Skin may become drier during the menopause transition, and existing conditions such as eczema can worsen.
Eczema can cause itching, roughness, thickened skin and discoloration. On darker skin, inflamed areas may look purple, gray or dark brown rather than bright red, which can make the condition harder to recognize.
A fragrance-free moisturizer, gentle cleanser and shorter, lukewarm showers may help with dryness. If itching persists or affects your sleep, a healthcare professional can help identify the cause and recommend treatment.
Acne isn’t just a teenage concern. Some women experience breakouts during midlife, including around perimenopause and menopause.
For women with deeper skin tones, the dark marks left after a breakout can linger. Avoid picking or aggressively scrubbing pimples, since additional irritation can contribute to discoloration. A dermatologist can help address both the acne and the marks it leaves behind.
Small, raised brown or black bumps on the cheeks, around the eyes or along the neck may be dermatosis papulosa nigra, commonly called DPN.
These bumps are common in people with darker skin tones, are generally harmless and may become more numerous with age. They also tend to run in families.
Removal is optional. If the bumps bother you, ask a qualified professional experienced with deeper skin tones about your options. Improper removal can leave scars or changes in pigmentation.
A keloid is a raised scar that grows beyond the boundaries of the original injury. It may develop after a piercing, surgery, acne or another injury to the skin.
Keloids can itch, feel tender or continue to grow. If you know you’re prone to them, talk with a dermatologist before getting an elective piercing or cosmetic procedure. Treatment options may include injections and other approaches, depending on the scar. www.aafp.org
Skin cancer is less common in Black people than in people with lighter skin, but Black skin can develop skin cancer.
Melanoma in people of African ancestry can appear on the palms, soles of the feet or under the nails—areas that are easy to overlook. See a healthcare professional about a spot that changes, bleeds, doesn’t heal or otherwise concerns you.
Make an appointment if you notice a new or changing dark patch, persistent itching, painful bumps, or a sore that doesn’t heal. You can also seek care if a skin concern is affecting your confidence or quality of life.
A dermatologist who understands skin of color can help you identify the cause and choose a treatment plan suited to your skin. The American Academy of Dermatology’s Find a Dermatologist tool lets you search for doctors with a focus on skin of color.
Your skin may change as you get older, but you don’t have to figure those changes out alone. With an accurate diagnosis, gentle care and patience, many common skin concerns can be managed.
Sanaa has previously shared that her approach to beauty includes caring for her skin and paying attention to what she eats. In a 2021 interview with Glamour, she said she liked using organic canola oil on her face throughout the day.
“I like this organic canola oil. It’s on Amazon and it’s called Camellia. It’s from Sweet Essentials and it’s $13.99. I have it all over my house; throughout the day I put it on my face and it’s so silky. It makes your skin so supple and moisturized. I love it.”
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