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Melasma Treatment

By Angela Maguire | Published on August 21, 2009 | 0 Comments

What is Melasma?

Melasma is a tan or dark skin discoloration usually found in irregularly shaped patches on the upper cheek, nose, lips, upper lip, and forehead. Melasma usually develops gradually, and is sometimes called “Chloasma faciei” or the “mask of pregnancy” when it occurs to pregnant women. Melasma may be epidermal or dermal, depending on how deep the discoloration goes into the layers of skin.

Who Needs Melasma Treatment?

Anyone who has been diagnosed with melasma may seek treatment. Melasma may affect anyone, but it is most common in women, especially those who are pregnant or taking hormone replacement therapy or  patch or oral contraceptives. Melasma also is more likely to occur in women and men who are of Native American, Jewish, German, or Russian descent. Women with a light brown complexion who live in extremely sunny climates are also more susceptible to melasma.

What causes Melasma?

Besides heredity, the use of oral/patch contraceptives, and the use of hormone replacement therapy, other conditions are also known to increase the risk of melasma.

Extreme sun exposure is a risk factor for melasma in women, because one cause for melasma is thought to be the stimulation of melanocytes (pigment-producing cells) by the female sex hormones estrogen and progesterone to produce more melanin pigments when the skin is exposed to sun.

Thyroid disorders may increase the risk of developing melasma because it can cause hormone imbalance that will produce more pigment-making cells when the body is under stress.

In rare cases, allergic reactions to medications and cosmetics have caused outbreaks of melasma.

What Kinds of Melasma Treatments are Available?

In cases where the melasma is caused by the use of hormone replacement therapy or oral or patch contraceptives, the symptoms of melasma often disappear completely a few weeks after one stops taking the hormone replacement therapy or oral/ patch contraceptives. When the melasma is caused by pregnancy, the symptoms often disappear a few weeks after giving birth.

Hydroquinone is a topical depigmenting agent used in treating melasma. It works by inhibiting the enzyme tyrosinase, which is key in the production of melanin. Hydroquinone does not destroy previously synthesized melanin and therefore does not bleach skin. However, it may take weeks to see results.

Facial peels with alpha hydroxyacids, or chemical peels with glycolic acid, are helpful in exfoliating the skin to rid of dead melasma-afftected cells. If you are using hydroquinone, however, it is best to avoid these peels, as the skin may become irritated with the use of both.

Tretinoin is an acid that increases skin cell turnover, and can therefore help reveal the underlayers of skin that have not been affected by melasma. This melasma treatment should not be used during pregnancy.

Azaleic acid is a topical treatment thought to reduce the activity of pigment-producing cells called melanocytes.

Cosmetic cover-ups, like specialized concealer, are used to diminish the appearance for discolored spots on the skin.

Laser treatment may be used in certain cases of melasma, although this treatment is expensive and is not effective in treating all varieties of melasma.

All melasma treatments options require the strict avoidance of sunlight, as any exposure to sun could counter treatment.

Potential Risks of Melasma Treatment

Those who are pregnant or may become pregnant may have to avoid certain treatments for melasma; speak to your doctor before starting melasma treatment if you are pregnant.

Dermal melasma is often unresponsive to treatment and certain treatments may worsen this condition.

The Bottom Line:

If you suffer from long-term melasma, several treatments out there ensure you can get rid of (or at least cover up) unsightly spots and discolorations. If you are pregnant however, or taking oral/patch contraceptives or hormone replacement therapy, your best bet may just be to wait it out and let the symptoms disappear on their own.

*Disclaimer: The information on this website is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.

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