What is Melasma?

Melasma is a very common skin disorder that presents as a dark discoloration (hyperpigmentation) of the skin. Dark- brown patches appear on sun-exposed areas of the face, particularly the cheeks, bridge of the nose, forehead, upper lip, and chin. It is most frequently seen in people with darker skin tones, including those of Hispanic, Asian, African, Indian, or Middle Eastern descent. Melasma can occur in both men and women, but about 90% of those affected are women.

What causes melasma?

Although the exact cause of melasma is unknown, there are many factors that have been known to trigger or worsen the condition. Pregnancy, oral contraceptive use, hormone replacement therapy, certain anti-seizure medications, and chronic sun exposure have all been associated with melasma.

What is the treatment?

Sometimes melasma may fade within several months after stopping birth control pills or hormone replacement therapy, or after delivering a child. If melasma does not fade gradually, there are a number of treatment options. There are a variety of creams available to treat melasma. Some of the most commonly used creams to treat melasma contain the active ingredient hydroquinone, a “bleaching” chemical. Some creams containing hydroquinone in a 2% concentration are available over the counter. A dermatologist may be able to prescribe hydroquinone in higher concentrations of 3-10%. Many preparations of hydroquinone may also contain ingredients such as tretinoin, glycolic acid, and topical steroids which may enhance the skin-lightening effect. Other lightening agents that have been used to improve the appearance of melasma include azelaic acid and kojic acid. Many dermatologists may also recommend chemical peels, microdermabrasion, or laser surgery treatments. These cosmetic procedures may be successful in treating melasma, but they should be performed under the care of a dermatologist in order to prevent any potential complications.

How can melasma be prevented?

Avoiding sun exposure and using a daily sunscreen are the two most important factors in preventing melasma. Melasma may worsen with even brief sun exposure such as walking to and from the car, driving and even sitting near a window, so it is essential to protect the skin from the sun daily. Sunscreens that provide broad-spectrum protection (protection from UVA and UVB light) are the best option. Find a sunscreen that includes a physical block such as zinc oxide or titanium oxide, with an SPF of 30 or higher. A new FDA approved sunscreen with Mexoryl SX has been shown to be effective on sensitive skin.

If you believe you may have melasma, call for an evaluation with Dr. John Kayal at 770-426-7177.