Melasma

What is it?

It is a common skin problem that causes brown to gray-brown patches of discoloration on the cheeks, bridge of the nose, forehead, and chin and above the upper lip. Typical patterns are seen in three locations: the central face, the cheekbones, and the jawline. There are 4 types: epidermal, dermal, and mixed and that found in people of color. Mixed type is the most commonly diagnosed type which means both the dermis and epidermis are affected. Some people also get melasma patches on their arms or neck. While it doesn’t cause any symptoms, many people dislike the way it makes their skin look. Melasma is a chronic condition and while it may fade spontaneously, it is likely to remain a problem that can be controlled with proper care and treatment. The best prevention is to avoid sun exposure and receive a life plan for your skin.

What causes melasma?

While the cause is not known, the combination of sun exposure, genetic predisposition and hormonal changes can trigger melasma. Sun exposure stimulates melanocytes, the skin cells that produce skin color. Sun exposure will make melasma worse in the summer, and often makes melasma return after fading.

Women are more likely to get melasma than men. It usually affects women in their reproductive years, and is very common during pregnancy, especially in women of Latin and Asian descent. Melasma is known as the mask of pregnancy. Birth control and hormone replacement therapy can also trigger melasma.

Other triggers can include medications and any medications known as photo sensitizers that make the skin sensitive to the sun. Also any products that can irritate the skin causing increased melanin production can accelerate development of melasma.

People of color are more likely to get melasma. People with family members with melasma are more likely to get it themselves such as Mothers Aunts and Sisters. People of color are more prone to melasma because they have more active melanocytes than those with lighter skin.

Diagnosis

During a consultation with Dr. Roberts, she will review your medical history and medications. She will take photos and examine your skin and determine your melasma triggers and how deeply the melasma penetrates your skin. She 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 Dr. Roberts will discuss with you.

Treatment options

Your treatment options will depend on Dr. Roberts considered medical judgment. Treatments and may include topical treatments like Hydroquinone – a skin lightening creams in prescription form which may be combined with trentinoin (retin-A) and corticosteroids, or another substance to lighten melasma.

Procedures such as a chemical peel, laser therapy or microdermabrasion may be appropriate. Regardless of the treatment, in order to ensure treatment does not fail, it is important to minimize sun exposure and use a blocking sun screen that contains zinc oxide or titanium dioxide which block UVA and UVB rays Many chemical sun blocks do not effectively protect against both UVA and UVB rays.

Dr. Roberts cares deeply for people of color and their dermatologic needs and desires. Under her care, you can be confident that she will provide you with a good outcome and an improved quality of life. It may take a few months and a few different approaches. Further, once your melasma clears, it will be important to follow her maintenance plan and use good skin care products and sun screen. Also you should avoid waxing as it causes skin inflammation which can worsen melasma. There are other hair removal procedures that may be better for you.