Understanding Melasma and Treatments

Submitted by Patrick Hatfield on

What is Melasma?

Melasma is a common pigmentation disorder that results in brown or gray patches on skin, most commonly on the face.  The most common areas are the bridge of the nose, forehead, cheeks, and upper lip.  These spots can also appear on the forearms, neck, and shoulders.

Who gets Melasma?

Melasma is most commonly occurring in women, with only 10% of males being affected. Women with darker complexions and who are pregnant are more likely to develop melasma. 

Causes

Causes are not fully understood, but may be due to the malfunction of the color-making cells in the skin, called melanocytes.  Because of this, people with darker skin tones are more likely to develop melasma, due to the increased number of melanocytes they possess.  Other triggers can be changes in hormones during pregnancy, hormone treatment, or birth control pills.  Sun exposure is another trigger for melasma to form.  There are also skin care products that can irritate the skin and leave the skin susceptible to melasma formation.  There may also be a genetic component, due to related individuals displaying melasma within families.

Symptoms

The biggest symptom of melasma is the development of discolored skin patches.  There is often a lack of any physical symptoms.  The patches are bothersome only due to their appearance. 

Diagnosis

Diagnosis is easy and usually done visually by a dermatologist.   Melasma can also resemble other skin conditions, so a skin biopsy may be the best confirmation of the skin disorder.  It is also a great way to rule out more serious skin disorders.  Your dermatologist may also use a device called a Wood’s light to see the skin more closely.

Treatment

Since the disorder is only skin discoloration without any other physical issues, it does not usually need to be treated for medical reasons.  However, some people will want to remove the discoloration due to the appearance on the face.  If the melasma is related to hormonal changes, the melasma may clear up on its own when birth control pills are no longer used or after a pregnant woman gives birth.  If melasma lasts for years and does not fade, treatment could be sought out to help remove or at least fade the patches.

Dermatologists may prescribe several treatment creams to help with the discoloration.  The first line of defense is often hydroquinone, which comes in the form of a cream, lotion, or gel.  This cream helps to lighten the color of the skin patches on the face.  Corticosteroids can also be prescribed to help lighten the color of the melasma patches.  Once topical medications have been exhausted and have not shown the results desired, your dermatologist may recommend microdermabrasion, chemical peels, laser treatment, and even light therapy.

Prevention

To ensure that you are not a victim of melasma, try to reduce your exposure to the sun and utilize sunscreen whenever you are outdoors.  Wearing a hat can also be a great way to keep the sun off of your most sensitive areas, like your face and your shoulders.