What Is Melasma, And How To Treat It

Melasma is a very common skin problem which causes unwanted skin pigmentation. This condition, so common for moms-to-be that it is also known as “the mask of pregnancy”, causes brown and greyish-brown patches to form on the face, especially cheeks, nose, and forehead. It can also form on the neck, chest, and arms.

What is Melasma?

Due to its hormonal causes, Melasma is far more common in women than men. It is also more common in those with brown skin that tans well, rather than those with fair or black skin. There is a genetic predisposition to Melasma.

There are three different types of Melasma, and they are dependent on the depth of the pigment. The three types are:

• Epidermal: In epidermal melasma the patches of pigmentation have clearly defined borders, and are usually dark brown in colour. Epidermal Melasma is the type that responds quickest to treatment.
• Dermal: Dermal Melasma is light brown or bluish in colour, with undefined borders. Dermal Melasma responds poorly to treatment.
• Mixed: A blend of dermal and epidermal Melasma, mixed Melasma is the most common type. Since it’s a mix of both types, the patches will appear light and dark brown, and blueish, and the condition will partly respond to treatment.

Diagnosis of Melasma is pretty easy due to the outward manifestation of the condition, however Melasma can be confused with other skin pigmentation disorders such as postinflammatory pigmentation, drug-induced pigmentation, or lentigo. If there is confusion, a skin biopsy will be taken in order to diagnose the condition.

What causes melasma?

Melasma is related to hormonal changes, such as those experienced during pregnancy. It might also form if you’re taking birth control pills or having hormone replacement therapy, or are suffering from hormonal imbalance. These factors mean that women are far more likely than men to develop melasma.

However, sun damage is shown to be the most common cause of Melasma. Although it is harmless, melasma can cause embarrassment and lack of self confidence. Fortunately, melasma can be minimized or treated.

How can melasma be treated?

Melasma may fade on its own if the trigger is removed, for example if caused by pregnancy, the melasma fades after giving birth. However, other cases are long lasting and more severe, especially if the condition is dermal Melasma.

Severe cases of melasma should be treated by your dermatologist, who may recommend chemical peels with glycolic acid or laser treatments if topical creams have no effect.

Topical creams for melasma:

• Hydroquinone Hydroquinone is the best first treatment for melasma. Hydroquinone is a pigment cell suppressing agent. This chemical compound is applied to the skin to inhibit the growth of the abnormal pigment cells. This chemical also lightens the existing abnormal pigmentation.Hydroquinone can be purchased in some over the counter creams, or prescribed by your dermatologist. Dermatologist-prescribed creams have stronger active ingredients. Dermatologist often prescribe tretinoin or corticosteroids with hydroquinone. This treatment is known as a triple cream.Hydroquinone can have side effects, including ochronosis. This is a dark blue pigmentation, which could be permanent.
• Azeliac Acid Azeliac acid, a naturally-occurring acid, also prevents abnormal pigmentation. It selectively targets the abnormal cells, leaving the normal cells. It has fewer side effects than hydroquinone, but can cause redness and burning.
• Kojic acid Kojic acid, a powerful antioxidant, also inhibits the growth of abnormal pigment cells. As one of the side effects is dermatitis, kojic acid is usually recommended if other treatments are not tolerated.
• Sun protection As melasma can be triggered by exposure to the sun, protecting your skin from the sun is one of the most common treatments. Wear sunscreen, but also wear a wide brimmed hat if you must go into the sun.

Cosmetic Treatments:

Chemical peels are effective when it comes to minimizing the appearance of Melasma. At Fairview Cosmetic Surgery, we provide a variety of chemical peels, including several that reduce skin pigmentation.

• TCA peel: A Trichloroacetic acid treatment is a medium level chemical peel and is used to renew the face and hands. TCA is recommended for darker skin types, and is used to even out pigmentation.
• PCA peel: A PCA peel is a light to moderate treatment that helps exfoliate and even out skin. PCA is used to treat uneven pigmentation, as well as sun damage, making it an ideal option for those with Melasma.
• Mandelic Acid peel: This peel is specifically for those with Melasma, and sun damaged skin. A mandelic acid peel lightens skin pigmentation, and is safe and gentle.
• Sensi peel: The sensi peel is specifically for ethnic skin types with sensitive skin. Since darker skin types are more prone to Melasma, this is a good option for those with Melasma or sun damage. As evidenced by the name, the sensi peel is specially formulated for those with sensitive skin.

Please, consult with our team today to learn which peel may be right for you!