What is Melasma?

What is Melasma? Melasma is a common condition characterised by brown or blue-grey patches on the skin. Most often found on the face, melasma can develop in other areas including your arms and neck. You may notice symmetrical brown or blue-grey patches, particularly on your cheekbones, forehead, nose and upper lip.

Melasma results from the overproduction of melanin, the skin’s natural pigment. Melasma can be superficial (epidermal), deep (dermal) or a mixture of both types, depending on the depth of increased melanin within the skin.
Epidermal melasma tends to respond better to treatment whilst deep, dermal melasma is more difficult to treat.

Who is prone to Melasma?

Anyone can get melasma, but it is more common in women than men. Melasma is most common in those who tan easily or have naturally darker skin. Melasma tends to develop between the ages of 20 and 40.

What are the causes of Melasma?

Whilst we don’t yet know the exact causes of melasma, we do know that both genetics and hormones play an important role in the condition.
In one study, 60% of those experiencing melasma reported a family member also had melasma.

Pregnancy, oral contraceptive pills and other hormonal therapies are common triggers for melasma. Up to 50% of all pregnant women develop melasma, which is why the condition is often known as the “mask of pregnancy.”

Several studies have shown an association between melasma and thyroid disorders, especially hypothyroidism and thyroid autoimmune disease.

Perfumed soaps, toiletries, and cosmetics may cause a phototoxic (light-induced) reaction that triggers or exacerbates melasma.
Heat is also a known trigger. It’s worth considering avoiding the sauna or steam room and using a cool setting on your hair dryer to keep heat off your face. Take a cool shower after exercising rather than a hot bath.

By far the most significant known trigger for melasma is exposure to UV light, either from the sun or from tanning beds.

What is Melasma and how should you protect your skin?

An effective year-round sun protection regime is vital in the treatment of melasma.

Arm yourself with a broad-spectrum mineral-based SPF and apply liberally at least 15 minutes before you go outside. Reapply every two hours, especially after sports or swimming. I tend to reach for Elta MD’s UV Clear SPF 46 and Kiehls Ultra Light UV Defense Mineral Sunscreen.

For me, a wide-brimmed hat is a must to keep the sun’s rays off the face, hair line and neck. I like https://lackofcolor.com.au/ 

Treatments for Melasma

Melasma can make you feel self-conscious and you may want to hide your skin under layers of makeup. Melasma is a condition that can be controlled, not cured, and often a combination of treatments will yield the best, longest-lasting results.
Over-the-counter skin care products that contain certain active ingredients can be a good first step. Look for products that include:

• Arbutin
• Azaleic acid
• Glutathione
• Kojic acid
• Mandelic acid
• Niacinamide
• Retinol
• Tranexamic acid
• Vitamin C

Prescription triple combination creams containing hydroquinone, a retinoid and a topical steroid can be very effective for melasma, especially epidermal melasma.

There has been some controversy surrounding hydroquinone, but this pigment fader is quite safe to use for up to several months at a time. Triple combination creams can irritate the skin, so start slowly and only increase as advised by your doctor or dermatologist.

Dermamelan is a highly effective in-clinic chemical peel used to treat melasma. It contains a mix of ingredients including azaleic and kojic acids. There is some downtime with this treatment, and you should expect up to two weeks of redness and peeling. Follow-up includes several months of applying an at-home cream. Dermamelan’s results in treating melasma are impressive and it is safe for all skin types.

A bespoke course of microneedling is an effective treatment for melasma, especially epidermal melasma. Fine needles are used to create a micro-injury in the skin. This encourages the body’s natural healing response. In a tailored course, the needles are delicately adjusted depending on the area of concern.

Platelet Rich Plasma (PRP) is an effective and natural skin rejuvenation therapy which harnesses the power of your own blood plasma to stimulate growth factors within the skin responsible for healing and collagen and elastin production. Studies have shown it has good results in reducing melasma.

Injectable tranexamic acid (TXA) is a safe and efficacious option for melasma. Tranexamic acid is injected locally into affected areas, gradually lightening discolouration and evening skin tone. It is suitable for all skin types and may be combined with other treatments to amplify results. TXA may also be taken orally for limited periods to improve melasma.

Lasers should be used with extreme caution in the treatment of melasma. Intense Pulse Light (IPL) and Fraxel may even cause an increase in pigmentation in the long term. Pico laser is a safer option, utilising low energy and minimising heat, even then a strict topical treatment regimen is still needed to prevent reoccurrence or a flare-up.

If melasma is affecting how you feel about yourself, consult a dermatologist about developing a treatment plan tailored specifically to your needs.