That “Moustache” Above Your Lip Might Actually Be Melasma

Melasma on the upper lip and cheeks. Image sourced from DermNet.

You’ve tried concealer. Maybe you’ve tried waxing or threading. But that dark “moustache” shadow above your lip keeps coming back. As Dr. Annie shared in her latest IG Reel, it isn’t always hair, makeup, or a bad tan. Sometimes it’s melasma, and the good news is that treatments actually work.

What Is Melasma?

Melasma is a common skin condition that causes brown to grey-brown patches on the face, usually on the cheeks, forehead, nose, chin and upper lip. On the upper lip it often looks like a faint moustache or a shadow, which is why so many people try to wax, thread or cover it before realizing it’s pigment, not hair.

Patchy melasma across the cheeks, nose and upper lip. Image sourced from DermNet.

Why It Happens

Melasma is usually driven by a mix of triggers:

• Sun and visible light: UV rays and even visible light switch on your pigment cells. That’s why melasma often looks darker in the summer.

• Hormones: pregnancy, birth control pills and hormone therapy can trigger or worsen it. It’s often called the “mask of pregnancy”.

• Genetics and skin tone: it’s more common in women and in medium to darker skin tones, and it often runs in families.

• Heat and irritation: heat, harsh skincare, and waxing or threading on the upper lip can all make the pigment worse.

Melasma is more common in medium to darker skin tones. Image sourced from DermNet.

Derm Takeaways: What Actually Helps

• Daily sunscreen is non-negotiable. Use a broad-spectrum SPF 30+ every day, rain or shine. Tinted mineral sunscreens with iron oxides also block visible light, which regular sunscreen misses. New to SPF labels? Decode your sunscreen bottle here.

• Prescription creams work. Dermatologists commonly use hydroquinone, tretinoin, azelaic acid and combination creams, tailored to your skin to limit irritation.

• Tranexamic acid for stubborn cases. Topical tranexamic acid, or oral tranexamic acid prescribed for the right patient, can help melasma that won’t budge.

• Be careful with lasers and harsh peels. The wrong procedure can make melasma darker, especially in deeper skin tones. Get a diagnosis first.

• Think maintenance, not a one-time fix. Melasma can come back with sun or hormone changes, so a long-term plan keeps your results.

Is It Really Melasma?

Not every dark upper lip is melasma. Dark marks left behind after waxing or irritation (post-inflammatory hyperpigmentation), fine hair, and other pigment conditions can look similar but are treated differently. A dermatologist can tell them apart, often in a single appointment.

How DermCafé Can Help

Skip the clinic wait and get a video appointment with a board-certified Canadian dermatologist at DermCafé:

• Fast clarity: confirm whether it’s melasma or something else

• Tailored plans: from the right sunscreen to prescription treatments

• Follow-through: we check in to make sure your skin is improving

• In many provinces, there is no fee with your valid provincial health card!

👉 Book your video appointment and let a real Canadian dermatologist help you understand, and treat, what you’re seeing. Want to read more first? Learn more about melasma.