Melasma is a common skin problem. It causes darkening of the skin in brown to gray-brown patches, usually on the face. Melasma most commonly affects the face occuring on the cheeks, mid-face, forehead, chin, and above the upper lip.
Melasma can be prevented and treated with strict sun protection. This means wearing sunscreen every day and reapplying the sunscreen every 2 hours. The appropriate sunscreen should be broad-spectrum SPF 30 or greater. Practicing sun avoidance and proper sun protection by wearing wide-brimmed hats when you are outside is also helpful to prevent worsening of melasma.
Melasma is much more common in women than in men. Pregnancy is a common trigger for melasma as changes in hormones can worsen melasma.
What are the signs of Melasma?
Brown or gray-brown patches on the face commonly appear on the:
- Bridge of the nose
- Above the upper lip
Who gets melasma?
- Women are more likely to get melasma. Only 1 out of 10 cases of Melasma involves men.
- People with skin of color such as those of Hispanic, North African, African-American, Asian, Indian, Middle Eastern, or Mediterranean descent
- People with a family history of melasma.
How do dermatologists diagnose melasma?
Dermatologists can diagnose most patients by examining their skin. To see how deeply the melasma penetrates the skin, your dermatologist may look at your skin under a device called a Wood’s light. To rule out another skin condition, your dermatologist may need to remove a small bit of skin. This procedure is called a skin biopsy. A dermatologist can safely and quickly perform a skin biopsy during an office visit.
How do dermatologists treat melasma?
Melasma can improve at times when caused by a specific trigger such as pregnancy or birth control pills. When a woman delivers her baby or stops taking the birth control pills, melasma can fade.
If the melasma does not improved, there are several melasma treatments available. These treatments include prescription medications such as hydroquinone, tretinoin, and corticosteroid creams. Certain gentle acids such as azelaic acid or kojic acid can help lighten melasma. In severe cases, oral medications may be required to improve the appearance of Melasma.
If prescription medications are not effective, procedures for melasma may be helpful. These procedures include a chemical peel, microdermabrasion, laser treatment, or a light-based procedure.
Melasma can be a stubborn condition. Treatment may need to be continued once the skin has improved to prevent the melasma from worsening. Strict sun protection can also help prevent melasma from returning.