What is Melasma?
Melasma is a common skin condition that causes brown to gray patches on the face. It is commonly seen on the cheeks, bridges of the nose, chin, forehead, and above the upper lip. The neck and arms, as well as other portions of the body can also have melasma. It is most commonly seen in woman ages 20 to 50, and is caused partly from the sun, hormonal changes and genetics. It is possible for males to have melasma, but it is rarely seen. Most seen with melasma have daily exposure to the sun, but heat can also be a factor in this skin condition. It is more common in pregnant woman, especially those with Asian and Latin descents. People with olive skin tones, such as those from the Middle East, Asians and Hispanics, have a higher likelihood of getting melasma.
What causes Melasma?
While there is no known cause to melasma, it is suspected that hormone replacement therapy, pregnancy, birth control pills, a family history of melasma, race, and anti-seizure medications, as well as other medications, play a prime role in the disorder. The leading case of the disorder is believed to be exposure to the sun.
Melasma symptoms and signs
The only sign and symptom of melasma are the brown to gray patches found on the face or the body. There are no other signs to look for. A doctor will be able to look at the skin to determine if melasma is present. To see how deeply melasma goes into the skin, a doctor can use an instrument called a Wood’s light. Since melasma looks similar to other skin conditions, the dermatologist may do a skin biopsy to rule out other skin disorders and conditions.
There are many ways that one can treat melasma. Sometimes it will fade on its own. Other times a woman can stop birth control pills and they will see an improvement. However, if birth control pills are desired by the woman, she can use hydroquinone. This is often used to treat the skin first in patients with melasma. It is applied to the skin and will lighten it. It can be in a lotion, gel, cream or liquid form. Sometimes they are available without a prescription, however, a higher strength may be needed.
Trentinoin and corticosteroids can be used to lighten the skin as well. Often times they are prescribed as a cream together in conjunction with hydroquinone. This is called a triple cream.
To lighten the melasma, a dermatologist could prescribe azelaic acid or kojic acid. If nothing is working to help treat the melasma, a medical procedure may need to be performed. A chemical peel is often used for this. Microdermabrasion and dermabrasion can also be used. It will need to be tailored to fit the person with the melasma to make sure it fits their skin needs properly.
Melasma has a very good outcome. It can take a few months to see improvements in the skin. Maintenance therapy may be needed in some cases to ensure that the melasma does not come back. To prevent melasma, always wear a sunscreen, protective eye wear, and a wide brimmed hat. Sunscreen should be applied to the skin at least 20 minutes before heading outdoors, and reapplied every 2 hours or if the skin gets wet or excessive sweating takes place. Wear it year round as the sun will trigger melasma. Pick a sunscreen that is at least SPF 30, has broad spectrum coverage, and contains zinc oxide or titanium oxide to block out the sun’s rays. Use all medications as directed by your doctor. To cover up existing melasma, use a makeup with yellow or white based undertones.