Melasma

Melasma is a very common skin condition that causes brown to grayish-brown patches on the cheeks, nose, forehead, chin, and upper lip. Most patients with melasma are women, and the condition is more common in people with darker skin, such as those of Asian, Latin or Hispanic, Mediterranean, Indian, Middle Eastern, and African descent. The cause of melasma is not entirely clear, although sun exposure and changes in hormones seem to be important in stimulating the skin’s pigment producing cells. Melasma likely occurs when the color-making cells in the skin (melanocytes) over produce melanin or color. People with skin of color are more prone to melasma because they have more active melanocytes than people with light skin.

Ultraviolet (UV) light from the sun stimulates the melanocytes. In fact, just a small amount of sun exposure can make melasma return after fading. UV exposure makes melasma worse in the summer and causes it to return quickly after treatment, if the skin is not well protected from the sun with sunscreen and broad brimmed hats. Hormonal changes have been known to contribute to melasma. Pregnant women are often susceptible to melasma. When melasma appears in pregnant women, it is called chloasma, or the ‘mask of pregnancy’. Some medications such as birth control and skincare products that affect one’s hormones can lead to melasma. In addition, if a product irritates your skin, melasma can worsen.

How is melasma diagnosed?

Melasma is most often diagnosed clinically by a dermatologist looking at your skin. Melasma does not cause any pain or symptoms.

How is melasma treated?

Treatment can be challenging depending on where the pigment is located in your skin. Pigment closer to the skin’s surface is more easily treated, while deeper pigment can be very difficult to treat and tends to take longer. Treatment often includes a combination of therapies including:

Sun protection

Sun protection is one of the most common treatments for melasma. Since sunlight triggers melasma, it is important to wear sunscreen daily. Choose a sunscreen that offers broad-spectrum protection, a Sun Protection Factor (SPF) of 45 or higher, and zinc oxide and/or titanium dioxide to physically limit the effects of the sun’s rays on your skin.

Skin bleaching and other lightening creams

Some products can be used to lighten the appearance of melasma such as Hydroquinone, Tretinoin and topical steroids. These products may be suitable for minimal cases of melasma or in combination alongside more aggressive procedures.

Procedures

Procedures for melasma include a chemical peel, microneedling, laser treatment, or a light-based procedure.

Schedule a consultation

We understand that melasma is a frustrating chronic condition and we look forward to working with you to devise a successful treatment regimen. Schedule a consultation with our board-certified dermatologist, Dr. Jenna Queller, today.