Melasma is a common chronic skin condition. The symptoms of melasma are symmetrical & blotchy, brownish facial pigmentation. Moreover, it usually appears on the face – cheeks, forehead, bridge of the nose, above the upper lip, chin.
Melasma is a condition in which brown patches appear on parts of the skin exposed to the sun.
This is common in pregnant women and often called “the mask of pregnancy”. In fact, this appears as freckle-like spots forming large, flat, brown patches.
The pigmentation is a result of the overproduction of melanin. People who tan easily or have naturally brown skin are prone to melasma because they have more active melanocytes compared to people with lighter skin.
Causes of Melasma
Melasma depends on your genetic predisposition. A few of the other triggering factors are:
Uncontrolled exposure to the sun is the leading trigger as UV light from the sun stimulates the melanocytes, increasing melanin production.
Internal hormonal changes, as seen in pregnancy, stress, thyroid disorders as well as exogenous hormone treatments in the form of oral contraceptives, intrauterine devices, hormone replacement therapy, are all implicated in the triggering of melasma.
Certain medications like anti-seizure drugs, anti malignant drugs could also act as triggers.
Scented soaps, toiletries, cosmetics and skincare products that irritate the skin. Therefore, this may increase melanin production and accelerate melasma symptoms.
Do & Don't for Getting Melasma
DO: Use physical sun protection like scarves, jackets and hats.
DO: Exfoliate every 1o days.
DO: Follow a regular skincare routine.
DON’T: Spend too much time in the heat, saunas or steam rooms.
DON’T: Take any medication without consulting your doctor.
Types of Melasma
In this condition, the excess melanin layers on keratinocytes present in the epidermis. In fact, this type of melasma has patches with well-defined borders and respond well to treatment.
In this condition, the excess melanin may be deposited in the inner layer of skin called the dermis. Moreover, this type of melasma has unclear borders and does not respond well to treatment.
In this condition, pigmentation occurs in the epidermis as well as the dermis.
This type n dark-complexioned individuals.
Patterns of Melasma
Melasma occurs on both sides of the face, indistinct patterns such as -
This occurs on the forehead, cheeks, nose and upper lip. This is the most common pattern.
This occurs on the cheeks and nose.
This occurs on the jawline.
Treatments of Melasma
Melasma may clear out spontaneously, without treatment. This may happen especially in pregnant women after the delivery is complete. This happens when any hormonal imbalance regularises. Pregnant and breastfeeding women need to follow the instructions given by the dermatologist, as some treatments may prove harmful to the foetus and the newborn.
The doctor will assess the skin to diagnose melasma and may recommend treatment based on the cause.
Some of the treatment options are:
Hydroquinone inhibits tyrosinase, which is an enzyme involved in melanin production. Therefore, it decreases the melanin levels in skin. Hydroquinone is a lightening or depigmenting topical agent which is available in cream, lotion, gel, or liquid forms. In fact, it is available over the counter in low doses (2%), and by prescription in higher doses (4%).
However, it causes darkening of skin with overuse at high concentrations. If this happens, it should be discontinued immediately. When used under supervision, hydroquinone is ‘gold standard’ of melasma treatment.
Retinoids and corticosteroids:
Retinoids increase skin cell turnover and allow fresh cells to form quickly. Tretinoin creams contain retinoids that seem to have efficacy in treating melasma. Usually, dermatologists recommend retinoids in combination with other creams like azelaic acid or hydroquinone. There are mild side effects like peeling, dry skin, and irritation. On the other hand, corticosteroids work by lightening the affected areas.
Other topical medication:
Azelaic acid (20%), kojic acid, cysteamine hydrochloride (5%) may also be effective in treating melasma. It is important to do a patch test to rule out the possibility of any allergy.
Chemical peels exfoliate the top layers of the pigmented skin. Moreover, the dermatologist will choose the type and strength of the chemical peel best suited to the individuals' skin type. In fact, only dermatologists must administer Chemical peels.
Microdermabrasion is a form of mechanical exfoliation. In this treatment, a vacuum suction and an abrasive material exfoliate the top layers of skin. Moreover, this treatment may require multiple sessions for best results. In fact, dermatologists combine this treatment with other treatments.
There are various types of Lasers. Dermatologists assess your skin type and level of pigmentation. Accordingly, they choose the right laser for you. Lasers are one of the most effective forms of treatment.
Exposure to the sun is the leading cause of melasma. Therefore, sun protection is the most important step of any treatment. A broad-spectrum sunscreen with a 30 SPF should be used daily. In fact, one must re-apply it every few hours. The sunscreen can be applied over any of the topical medicines or creams. Using sunscreen regularly enhances the effectiveness of other treatments.
Melasma generally fades on its own. However, some people may want to treat it for cosmetic reasons. Patients must complete the treatment. READ MORE
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Melasma – Q&A
Melasma is usually common in women and seen most commonly in their pregnancy and due to it, melasma is also called or known as “Mask of pregnancy”. Melasma rarely appears to men due to genes, hormonal changes, sun exposure, etc. They seem like freckle spots which then...
Melasma is usually common in women and seen most commonly in their pregnancy and due to it, melasma is also called or known as “Mask of pregnancy”. Melasma rarely appears to men. It occurs in men due to genes, hormonal changes, sun exposure, etc. Melasma seems...
Melasma is a very common skin pigmentation. This usually appears as asymmetrical, blotchy, brownish colored facial pigmentation. This condition is more common in females than males. This pigmentation usually starts between the age of 20 to 40, but can also begin in...
As you have mentioned you have melasma & under eye dark circle problem. Melasma can occur because of many different reasons. If anybody in your family has melasma, then your more prone to get it, a lot of sun exposure without protection is also the important...
Melasma is a common skin problem which causes brown to gray-brown patches. Melasma also is known as butterfly Rash, chloasma faciei or mask of pregnancy. In Marathi, it is commonly known as in Maharashtra Vang. It is most commonly seen during pregnancy so that’s why...