Melasma

Melasma is a common skin condition characterized by brown or gray-brown patches, most often on the face. The patches typically appear on the cheeks, the bridge of the nose, the forehead, the chin, and above the upper lip. They can also appear on other parts of the body that get lots of sun, such as the forearms and neck.

One of the most common causes of melasma is hormone fluctuation, which is why it’s often associated with pregnancy (sometimes called “the mask of pregnancy”) and women who are taking oral contraceptives or hormone replacement therapy. However, men can also develop melasma.

The exact cause of melasma remains unclear, but several factors can trigger or worsen the condition, including:

Sun Exposure: Ultraviolet (UV) light from the sun stimulates the melanocytes, which can increase melanin production, leading to melasma.

Hormonal Changes: Pregnancy, birth control pills, and hormone therapy can trigger melasma due to changes in hormone levels.

Cosmetics: Skin products that irritate the skin may worsen melasma.

Skin Colour: It is more common in people with tan or darker skin types, particularly those with Hispanic, Asian, Indian, Middle Eastern, or Mediterranean backgrounds.

There is no cure for melasma, but several treatments can help minimize its appearance:

Sun Protection: This is a key component in the treatment of melasma. It includes wearing sunscreen every day and reapplying it every two hours, wearing hats or clothing that block sunlight, and seeking shade when the sun is at its peak.

Topical Treatments: These can include ingredients such as hydroquinone (which lightens skin), tretinoin and corticosteroids (to help lighten and improve skin that has thickened from melasma), and other agents like azelaic or kojic acid.

Procedures: In-office procedures like chemical peels, pico second technology can be helpful when melasma does not respond to topical treatments.

Because melasma can be persistent and often recurs, treatments may need to be repeated and continued maintenance therapy is often necessary. It is important for patients to follow up with their skin specialist to monitor and adjust treatment as needed.