What is Melasma?

Melasma is a common pigmentation disorder that causes brown or gray patches to appear on the skin, primarily on the face.
The most common areas for melasma to appear on the face include:

• the bridge of the nose
• the forehead
• the cheeks
• the upper lip

Melasma may also appear on other areas of the body, especially those exposed to a lot of sunlight. These areas may include:

• the forearms
• the neck
• the shoulders

According to the American Academy of Dermatology, only 10 percent of all cases of melasma occur in men. Women with darker complexions and who are pregnant are at greater risk of developing melasma.

Causes

Doctors do not fully understand why melasma occurs. It may be due to the malfunction of the melanocytes (the color-making cells) in the skin, causing them to produce too much color.

As a result, people with darker skin tones are more likely to develop melasma, as they have more melanocytes than people with lighter skin.
Potential triggers for melasma include:

• changes in hormones during pregnancy (chloasma), hormone treatment, or while taking birth control pills
• sun exposure
• certain skin care products, if they irritate a person’s skin

Also, there may be a genetic component to melasma, as people whose close relatives have experienced melasma are more likely to develop it themselves.

Symptoms

The primary symptom of melasma is the development of discolored patches of skin. While it does not cause any other physical symptoms, some people find the appearance of these patches bothersome.

The most common area for patches of melasma to appear is the face. Common locations include the upper lips, bridge of the nose, cheeks, and forehead.

Less commonly, a person may also have patches on their arms and neck.

Diagnosis

Dermatologists find most cases of melasma easy to diagnose during a visual examination. However, since melasma can resemble other skin conditions, a dermatologist may take a small biopsy during the initial visit.
A biopsy involves removing a very small portion of the skin for further examination in a laboratory.

A doctor may also use a device called a Wood’s light to look more closely at the skin.

What are the types of melasma?

There are four types of pigmentation patterns in melasma:

1. Epidermal melasma is identified by the presence of excess melanin in the superficial layers of skin.
2. Dermal melasma is distinguished by the presence of melanophages (cells that ingest melanin) throughout the dermis.
3. Mixed melasma includes both the epidermal and dermal type.
4. Excess melanocytes are present in the skin of dark-skinned individuals

What strength of SPF sunscreen is recommended for melasma?

A daily sun protection factor (SPF) of at least 50 that contains physical blockers, such as zinc oxide and titanium dioxide, is recommended to block UV rays, but it is important to have a sunblock that also covers for UVA protection. Chemical blockers may not fully block both types of UV-A and UV-B as effectively as zinc or titanium. The regular use of sun protection enhances the effectiveness of melasma treatments.

What is the prognosis for melasma? Can you get rid of it?

Although melasma tends to be a chronic disorder with periodic ups and downs, the prognosis for most cases is good. Just as melasma develops slowly, clearance also tends to be slow. The gradual disappearance of dark spots is based on establishing the right treatment combination for each individual skin type. Melasma cases that do not successfully respond to treatment are due to excessive sun exposure.

Can you prevent melasma?

Sometimes melasma may be preventable by avoiding facial sun exposure. In most cases, prevention is difficult. Individuals who have a family history of melasma must take extra precautions to prevent melasma. The most important way to prevent the onset of melasma and premature aging is to avoid the sun. If exposure to sunlight cannot be avoided, then hats, sunglasses, and sunblock with physical blockers should be worn.

TREATMENT

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