What is Melasma and How is it Treated?

What is Melasma and How is it Treated?

Over the past 10 years, we have had hundreds if not thousands of women with medium or dark skin tones come to us with deep frustration with a facial pigmentation condition called Melasma.  Melasma is a hormonally linked, stubborn and incurable condition that causes patches of pigment on the cheeks, upper lip and forehead.  In many cases, the spots are so dark that they are very difficult to cover with makeup.  Although Melasma is a difficult condition to treat, there are options to control and manage it effectively.

Although the exact cause of Melasma is not known, the condition is commonly seen in women that are pregnant or have recently had a significant hormonal change.  This could be a change in birth control, a pregnancy, menopause, hysterectomy or even a thyroid condition.  It is much more prevalent in skin types such as Asian, Hispanics and Blacks that have a higher concentration of Melanin.   Melasma should not be confused with sun spots but many patients assume that Melasma is caused by the sun rather than by hormones because it gets darker when they are out in the sun.

Melasma is genetically linked.  In many cases, those that have the condition also have parents or siblings that have it as well.  Females are more prone to getting Melasma than males, and approximately 95% of the cases we see are female patients.  The condition is most prevalent in 30-50 year old females with medium or dark skin.

Other contributing factors for Melasma include sun exposure, heat and humidity.  High temperatures with high humidity seem to trigger the condition, so we often find that patients that have visited tropical locations see it for the first time during or after their vacations.  Saunas, spas and even prolonged hot showers can cause Melasma to worsen.  Cooking over a hot steamy stove or grill, using a curling iron every day or any other situation that involves having high heat next to the face for extended periods will trigger the condition for those that are predisposed.

There are many ways of treating the Melasma, but most are only marginally effective.  The most common treatment for Melasma is a bleaching cream or topical product that uses the active ingredient hydroquinone.  Hydroquinone is a medication that suppresses the development of the pigment (melanin) associated with Melasma.  Using the medication can help control and lighten the Melasma, but in many cases the condition is chronic and the spots will return when the medication is stopped.

We have found laser treatments to be a poor way to treat the condition.  Although there are several lasers that are FDA approved for the treatment of Melasma, we have found them to be riskier, more time consuming, more expensive and less effective than traditional hydroquinone formulations.  They are riskier because lasers can often make Melasma worse.  In the same way that sunlight can cause Melasma to darken, lasers can do the same.  Q-switched and fractional lasers, which are commonly used to treat the condition typically need multiple visits that run into the thousands of dollars, much costlier and more time consuming than using a medication at home.  Finally, some consumers will use chemical peels to treat Melasma.  While some benefit can be had from chemical peels, like all other options, the results are temporary and of little benefit.

If you’ve got Melasma, there are excellent treatment options, including hydroquinone.  Contact a dermatologist experienced in treating Melasma to learn more.


A Guest Post by Kevin DiCerbo
Feel free to email him questions at kevin.dicerbo@celibre.com

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