Melasma

Melasma is a common pigmentation disorder that causes grey or brown patches to appear on the skin, mainly on the face.

The usual areas for melasma to appear on the face are:

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

Melasma may also appear on other parts of the body, especially which are 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% of all cases of melasma occur in men. Women with darker skin tones and who are pregnant are at higher risk of developing melasma.

Causes of melasma

Doctors don't completely understand why melasma occurs. It may be due to the malfunction of the melanocytes (the colour-making cells) in the skin, causing them to produce too much colour.

So people with darker skin tones are more likely to develop melasma, as they have more melanocytes than people with lighter skin tone.

Potential triggers for melasma include:

• Hormonal changes during pregnancy, hormone treatment, or taking birth control pills
• sun exposure
• certain skincare products, if they are irritating

Also, people whose close relatives have experienced melasma dark patches on their face in their life are more likely to develop it themselves.

Symptoms of melasma

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

The very common area for melasma patches to appear in the face. Common areas include upper lips, cheeks, bridge of the nose, and forehead.

Very less usually, a person may also have patches on their arms and neck.

Diagnosis

Dermatologists find most cases of melasma easy to diagnose during their visual examination. However, since melasma can resemble other skin conditions, a dermatologist may take a small biopsy sample during the first visit or may also use a device called a Wood’s light to look more carefully at the skin.

Home Remedies and Lifestyle

Before you begin treatment, understand that melasma is stubborn. So, if you want to get good, long-lasting results, you have to commit to long-term maintenance.

Sun Protection Is Key

Protecting your skin from the sun is undoubtedly very important. Sun exposure is a major trigger factor for melasma development.

Even after treatment works and melasma has faded, you'll need to follow strict sun protection. Many people experience melasma returning completely after spending just a few hours in the sun.

To help your skin respond to other forms of treatment you may be using, it's best to plan on using sunscreen with a good SPF as part of your daily skincare routine. 

Melasma treatment at home

In general, home remedies aren't incredibly effective at improving the melasma condition. A few alternative remedies, like turmeric and aloe vera, have shown at least some success at improving melasma. However, there's not enough info to recommend aloe or turmeric as melasma treatments, and usual treatments work faster and provide better end results.

Other home remedies may actually make melasma worse. Don't apply things like lemon juice, ACV, raw onion, or garlic to your skin. These highly acidic ingredients can irritate your skin, which can lead to the darkening of the spots you're trying to lighten. 

Melasma Treatment

Treatment is not always required for melasma.

If hormonal changes, like during pregnancy or while taking birth control pills, have caused melasma, it will fade away after delivery or once a person stops taking the pills.

For others, melasma can last for years or even for the rest of their lives. If melasma does not fade over the period of time, a person can consult and get a treatment to help remove or fade the patches.

Melasma may come back even after successful treatment as not all treatments work for everyone

Treatment options for melasma include:

Hydroquinone

Doctors often use hydroquinone as the primary treatment for melasma. Hydroquinone is available in lotion, gel, or cream.

A person can apply the hydroquinone product directly to the patches of skin that are discoloured. Hydroquinone works in lightening the colour of the skin patches.

Corticosteroids and tretinoin

Corticosteroids and tretinoin come in creams, gels, or lotions. Both can help lighten the colour of the melasma patches.

Combined creams

In some cases, a dermatologist may choose to prescribe combination creams that may contain corticosteroids, hydroquinone, and tretinoin in one. These are called triple creams.

Additional topical medications

In addition to other medicated creams, a dermatologist may also prescribe azelaic acid or kojic acid. These acids can work to lighten the dark areas of the skin.

Medical procedures

If topical medications don’t work, a dermatologist may recommend procedures such as:

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

Some of these treatment options have potential side effects or may cause additional skin problems. It is best to speak to a doctor about all the possible risks.

If a person had melasma before, they can try to avoid triggers by:

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

Take Away

Melasma causes the formation of dark patches on the skin, mostly on the face. While these skin changes are harmless, some people may find them bothering.

Melasma treatment is effective for some people. Melasma that is due to hormonal changes may also fade over time, once those levels return to normal.