Melasma

The cause is not fully understood, but several factors are known to contribute to the development of melasma including skin type, sun exposure, genetic predisposition and hormonal changes. Sun is a major trigger. The UV rays stimulate melanocytes, the skin cells that produce skin color, leading to the formation of dark patches. Sun exposure will make melasma worse in the summer, and often makes melasma return after fading.

It typically affects women in their reproductive years, especially women of Latin and Asian descent. In addition to pregnancy, birth control and hormone replacement therapy can trigger melasma. People of color are more prone to melasma because they have more active melanocytes than those with lighter skin. People with family members with melasma are more likely to get it themselves.

Other triggers can include any medications known as photosensitizers that make the skin sensitive to the sun, such as some antibiotics. Some skin care products can also make the skin more sensitive to the sun and trigger melasma. Any products that irritate the skin causing increased melanin production can accelerate development of melasma.

During a consultation with your Ironwood Dermatologist, they will review your medical history and medications. They will discuss triggers identified including the use of hormone products and review your medications to identify potential photo-sensitizing drugs and skin care products.

Your provider will take photos and examine your skin to determine how deeply the melasma penetrates your skin. They will also rule out other skin conditions that resemble melasma.

Melasma may fade on its own, when the trigger is removed. Thus after delivery, or after discontinuing birth control pills it can fade. But many people have melasma for years. If it does not fade on its own, there are various options for treatment, which your Ironwood dermatologist will discuss with you.

Your treatment options will be determined by your dermatologist using their considered medical judgment. Your provider will discuss them with you.

• The most crucial aspect of melasma treatment is rigorous sun protection. This includes using broad-spectrum sunscreen with a high SPF, wearing wide-brimmed hats, and avoiding sun exposure during peak hours.
• Topical treatments include creams containing ingredients like hydroquinone, tretinoin, corticosteroids, azelaic acid, and kojic acid. These agents help lighten the dark patches by reducing melanin production.
• Chemical peels use acids to exfoliate the top layer of skin, promoting the growth of new, lighter skin.
• Microdermabrasion is a popular cosmetic procedure used to treat various skin conditions, including melasma. It involves the mechanical exfoliation of the skin’s outermost layer using a device that sprays fine crystals or a diamond-tipped wand. This process helps to remove dead skin cells and stimulate the production of new, healthy skin cells.
• Microneedling involves using tiny needles to create micro-injuries in the skin, stimulating collagen production and helping to lighten the patches.
• Laser treatments can target and break down the excess pigment. However, this method should be used cautiously, as it can sometimes worsen melasma. Laser therapy may be appropriate for patients who do not respond to topical treatments.