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Pigmentation - Melasma Treatment

Brown Patches or “mask of pregnancy” are the other names for, melasma.

What is melasma?

Melasma is the presence of brown or grayish brown patches, usually on both sides of the face, especially on cheeks, upper lip, nose, forehead or chin. This is caused by excessive production of melanin, the pigment that causes skin to tan. Melasma can be mild, moderate or severe depending on how much of your face is affected and how intense the pigmentation appears.

Who gets melasma and why?

Melasma is common skin condition that occurs predominantly in women. Men rarely develop melasma. It is estimated that up to 75% pregnant women and up to 35% of women using oral contraceptives are affected by melasma. Although anyone can have melasma, it is more common in people with light brown skin. Experts believe the pigmentation is caused by normal hormonal changes that occur when a woman beings taking birth control pills or hormone replacement therapy or during the second or third trimester of pregnancy” because of its visual appearance during pregnancy. Sun exposure is also a triggering factor.

Is melasma permanent?

Melasma may fade away without treatment after child delivery or after discontinuation of hormonal treatment (birth control pill or hormonal replacement therapy). However, dark patches may take a long time to lighten, sometimes even years and in some cases they may not disappear completely.

The time it takes for the pigmentation to fade varies from woman to woman. For some people, it may even worsen over time. In addition, if melasma fades after child delivery, it can return with each future pregnancy.

How to prevent melasma from getting worse?

Skin tanning occurs when melanin, the skin’s pigment, absorbs the energy of the sun’s ultraviolet rays. Melasma may be darker when skin is exposed to the sun as a result of the same process.

Avoiding sun exposure can help prevent further darkening of existing melasma as well as the formation of new patches. This is especially important for women who take birth control pills or hormone replacement treatments and for people who have had melasma in the past.
Apply sunscreen with SPF30 or higher on a daily basis. This will protect your face from harmful rays of the sun. If you are in the sun for longer period of time, you should wear a hat to protect your face.

What treatments are available for melasma?

Fortunately, you don’t have to live with melasma forever. Your dermatologist will be able to advise you for the best treatment.

There are 2 ways that are used to treat melasma:

Cosmetic: Use of various cosmetics to cover the dark areas is common. However, this method does not help melasma to fade.

Medical (OTC or prescription medications): Most common medications are aimed at inhibiting melanin production selectively, therefore causing a depigmenting effect.

Physical: Peelings with topical agents are used to remove several layers of discolored skin.

What are the benefits of new ‘combination therapies”? 

There is a new prescription treatment that can lighten moderate to severe melasma quickly and effectively. This treatment combines 3 active ingredients in an easy-to-use cream that is applied only once a day.

How to use this new treatment?

After washing your face with a light cleanser, apply a small amount of the cream to the affected area before bedtime. Moisturizers and cosmetics can be also applied over the cream.

Why should you see a doctor and ask for advice now?

Before starting any treatment against melasma it is important to consult a trained dermatologist. Reasons being:
  1. It is important to confirm the diagnosis and check that there is no underlying or associated skin disease that would require immediate and adequate treatment
  2. Melasma can worsen over time and even become permanent.
  3. Effective medical melasma treatments require a prescription. As these treatments may sometimes produce mild side effects they need to be under medical supervision.