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What is melasma?

Melasma is a common condition of pigmentation that causes the appearance of brown or gray patches on the skin, especially on the face.

The most prevalent places in which melasma occurs on the face include:

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

Melasma can also occur in other areas of the body, especially those that are exposed to a great deal of sunlight. These areas may include:

  • the forearms
  • the neck
  • the shoulders

About 10 percent of all cases of melasma arise in men, according to the American Academy of Dermatology. The risk of contracting melasma is higher for women with darker complexions and who are pregnant.

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Causes

Doctors do not truly grasp why melasma develops. It may be due to the malfunction of the skin’s melanocytes (color-making cells), causing too much color to be developed.

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

Potential melasma causes include:

  • changes in hormones during pregnancy (chloasma), hormone treatment, or while taking birth control pills
  • sun exposure
  • If they irritate the skin of a human, such skin care ingredients

There may also be a hereditary aspect of melasma, since it is more common for individuals whose close relatives have undergone melasma to acquire it themselves.

Symptoms

A lady checking her face on a mirror
Apart from changes in appearance, melasma does not cause any physical symptoms.

The appearance of discolored patches of skin is the main symptom of melasma. Although it does not trigger any other noticeable signs, the existence of these patches is bothersome for some persons.

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

An individual can also have patches on their arms and neck, less frequently.

Diagnosis

During a visual examination, dermatologists find most cases of melasma easy to diagnose. However, as melasma can be similar to other skin disorders, at the initial visit, a dermatologist can perform a small biopsy.

For further study in a laboratory, a biopsy involves taking a very small part of the tissue.

A practitioner can also use a system called a Wood’s light to look at the skin more closely.

Treatment

Melasma does not necessarily need medication.

If hormonal changes have induced melasma, such as those arising during pregnancy or when taking birth control drugs, it can disappear after delivery or until a person stops taking the medication.

Melasma will last for years for other people, or even for the remainder of their lives. An individual should seek medication to help remove or fade the patches if the melasma does not fade with time.

Not all treatments, however, work for all, and even after good treatment, melasma can come back.

Melasma treatment options include:

Hydroquinone

A person can apply hydroquinone lotion directly to melasma to lighten the skin.
A person can apply hydroquinone lotion directly to melasma to lighten the skin.

As the first line of therapy for melasma, doctors also use hydroquinone. As a lotion, cream, or gel, hydroquinone is available.

An individual should add the hydroquinone substance directly to the discolored skin patches.

There is hydroquinone sold over the counter, but stronger creams should also be administered by a doctor. Hydroquinone works by rendering skin patches brighter in colour.

Corticosteroids and tretinoin

It comes as creams , lotions, or gels containing corticosteroids and tretinoin. Both corticosteroids and tretinoin can help lighten the color of the melasma patches.

Combined creams

In certain cases, a dermatologist can choose to administer hydroquinone, corticosteroids, and tretinoin-containing combination creams in one. These are called triple creams.

Additional topical medications

Azelaic acid or Kojic acid can also be administered by a dermatologist in addition to or in lieu of other medicated creams. These acids function to lighten the skin’s dark regions.

Medical procedures

If topical medications do not work, a doctor may suggest procedures such as:

  • microdermabrasion
  • chemical peel
  • laser treatment
  • light therapy
  • dermabrasion

Any of these options for treatment include side effects or can cause further complications with the skin. It is safer to chat about all the potential dangers with a doctor or dermatologist.

If a person has previously had melasma, they may try to prevent causes by:

  • limiting sun exposure
  • wearing a hat when outside
  • using sunscreen

Outlook

Melasma causes dark spots, most commonly on the face, to form on the skin. While these changes in the skin are harmless, certain individuals can find them bothersome.

For certain patients, therapy is successful. When hormone levels return to normal, melasma that is due to hormonal changes can also diminish over time.