Melasma is a common skin condition that causes dark, discolored patches to appear on the skin, primarily on the face. It most often affects women, particularly those in their reproductive years, though it can also affect men. The condition can be frustrating and affect a person’s self-esteem, but the good news is that it can be managed with the help of a dermatologist. In this blog post, we’ll dive into what melasma is, why it occurs, and how dermatologists treat it.
What Is Melasma?
Melasma is a type of hyperpigmentation, which means that certain areas of the skin become darker than the surrounding skin. This is typically due to an overproduction of melanin, the pigment responsible for giving skin its color. Melasma usually presents itself as irregularly shaped, brown or grayish-brown patches that most often appear on the face, particularly on the cheeks, forehead, nose, chin, and above the upper lip. These patches are typically symmetrical, meaning they appear on both sides of the face.
While melasma can develop on other areas of the body that are frequently exposed to the sun, the face is the most common location.
This is why melasma is sometimes referred to as the “mask of pregnancy,” as it is frequently seen in pregnant women, but it can affect anyone regardless of pregnancy status.
Why Does Melasma Occur?
Melasma occurs when the skin produces excess melanin in certain areas. The exact cause is not fully understood, but several factors contribute to the development of melasma, and understanding these factors can help manage and prevent the condition.
- Sun Exposure: The most significant trigger for melasma is exposure to ultraviolet (UV) rays from the sun. UV radiation stimulates melanocytes (the cells that produce melanin), leading to an increase in melanin production. Even minimal sun exposure can worsen melasma or cause it to appear.
- Hormonal Changes: Hormonal fluctuations are a major leading cause of melasma, which is why the condition is more prevalent in women. Pregnancy, birth control pills, and hormone replacement therapy can all trigger melasma. During pregnancy, the increase in estrogen and progesterone can stimulate melanin production, leading to the characteristic dark patches on the face. This is why melasma is sometimes called the “mask of pregnancy” or “chloasma.” Women taking oral contraceptives or hormone replacement therapy may also notice the onset or worsening of melasma due to similar hormonal changes.
- Genetics: Genetics plays a role in the development of melasma. Individuals with a family history of the condition are more likely to develop melasma themselves. It tends to run in families, suggesting a genetic predisposition to the condition.
- Skin Type: People with darker skin tones are more likely to develop melasma. Those with a Fitzpatrick skin type III and higher (which includes individuals with olive or dark skin tones) are at an increased risk of melasma. This is because darker skin contains more melanocytes, which are the cells that produce melanin.
- Other Triggers: Certain medications can also contribute to the development of melasma. Additionally, stress, pregnancy, and certain cosmetics that cause irritation or sun sensitivity can be contributing factors.
How Does Melasma Affect People?
Melasma primarily affects a person’s appearance, which can cause emotional distress, especially if the condition is noticeable or persists. While melasma is not painful or dangerous, the dark patches can cause a person to feel self-conscious, particularly since the condition is most often located on the face. This can affect confidence and self-esteem, leading some individuals to avoid social interactions or feel embarrassed about their appearance.
For some people, melasma may be a temporary condition that fades on its own, especially after pregnancy or discontinuing hormonal medication. However, for many individuals, melasma is a chronic condition that can recur over time.
How Do Dermatologists Treat Melasma?
While melasma may not be completely curable, it is treatable, and our dermatologists regularly provide successful reduction in the appearance of melasma and help manage the condition long term through a combination of treatments and lifestyle changes.
Here are some common methods that our dermatologists use to treat melasma:
Sun Protection: The cornerstone of managing melasma is preventing further sun exposure. Since UV rays from the sun are the primary trigger for melasma, it is essential to protect the skin from the sun’s harmful rays. Dermatologists will recommend using broad-spectrum sunscreens with an SPF of 30 or higher every day, even on cloudy days or when indoors. Sunscreens should be applied liberally to all exposed skin, and reapplication every two hours is essential for adequate protection. Wearing hats, sunglasses, and protective clothing can further shield the skin from the sun.
Topical Treatments: For managing melasma, dermatologists typically recommend topical treatments that can help reduce pigmentation and improve skin tone. These treatments work by inhibiting melanin production and promoting skin renewal. While some of these treatments require a prescription, there are also over-the-counter options that can be used for ongoing maintenance.
- Skin-Lightening Agents: Dermatologists often recommend products containing skin-lightening ingredients that help fade dark spots. These products generally work by reducing melanin production, helping to lighten hyperpigmented areas over time.
- Exfoliating Agents: Ingredients like retinoids and acids (such as alpha-hydroxy acids or beta-hydroxy acids) can help to increase skin cell turnover, removing dead skin cells and fading pigmentation. Over time, this can improve the overall appearance of the skin.
- Antioxidants: Products containing ingredients like vitamin C can brighten the skin and reduce the appearance of dark spots. Vitamin C also helps protect the skin from further damage by neutralizing free radicals caused by sun exposure.
- For ongoing maintenance, dermatologists can recommend some over-the-counter options that can help maintain your skin’s appearance and prevent melasma from returning. However, it is essential to be cautious and only use products that are recommended by a professional. A reliable site for dermatologist-recommended products is The Skin Network by Dermatologists at www.theskinnetwork.com.au, where you can find trusted skincare solutions.
Always follow your dermatologist’s advice when using these products, and avoid over-the-counter solutions that have not been specifically recommended to treat melasma.
Chemical Peels: Chemical peels can be an effective treatment option for melasma as they work by exfoliating the outer layers of the skin, helping to fade dark spots and improve skin texture. However, it is essential to only undergo chemical peels at a dermatology practice under the supervision of a professional to avoid the risk of worsening melasma.
Not all chemical peels are suitable for treating melasma, and the wrong type of peel or strength of peel can exacerbate pigmentation issues and lead to ‘brush’ or ‘striping’ effect of pigment across the face. For instance, glycolic acid peels should be avoided, as they can cause further hyperpigmentation in individuals with melasma. Instead, dermatologists may recommend low concentration lactic acid peels or specifically targeted MelaPeels, which are more gentle and less likely to trigger hyperpigmentation.
To avoid pigmentation issues and ensure the best possible outcome, always consult with your dermatologist before undergoing any chemical peel treatment. Only a trained professional can determine the right type of peel for your specific skin type and condition, minimizing the risk of complications and helping you achieve the best results.
Laser Treatments: Laser treatments can be an effective option for melasma, but they should always be approached with caution and under the guidance of a dermatologist. Not all lasers are suitable for treating melasma, and using the wrong type of laser can worsen the condition.
Picosecond lasers are currently considered one of the best laser options for treating melasma. These lasers work by delivering rapid, high-energy pulses of light to the skin, which helps break down excess melanin and target the dark patches of pigmentation. Picosecond lasers are particularly effective because they use ultra-short pulses that can target pigment without causing excessive damage to the surrounding skin, minimizing the risk of further pigmentation or scarring.
However, it is crucial to consult with a dermatologist before undergoing any laser treatment for melasma. A thorough consultation is necessary to determine if you are a suitable candidate for laser therapy. Additionally, dermatologists will often recommend a preparatory treatment plan that includes sun protection, topical treatments and medications to reduce the risk of complications. These preparatory steps are essential for achieving the best results and minimizing the chance of the melasma worsening after the procedure.
Once the preparatory treatment plan is completed, and if the dermatologist determines that laser treatment is appropriate, picosecond lasers can be a highly effective option to help fade the dark patches associated with melasma.
Hormonal Management: Your dermatologist may discuss options for managing hormones, however, this approach may require the guidance of a gynecologist or endocrinologist.
Final Thoughts
Melasma is a common but manageable condition. With the right treatment plan, people living with melasma can reduce the appearance of dark patches and restore confidence in their skin. If you suspect you have melasma, it’s important to consult a dermatologist who can provide a personalized treatment strategy that may include sun protection, topical treatments, and other options to address your specific needs. With the right care, you can effectively manage melasma and achieve a healthier, more even complexion.