Conditions: Melasma

What is Melasma?

Melasma is a common skin issue which causes brown or grayish-brown areas on your skin, most often on the face. Typically people see melasma on their cheeks, forehead, on the bridge of their nose, lower chin, and/or above their lip. It has been known to appear on untypical parts of the body that tend to get sun. Melasma often fades on its own after pregnancy or after an affected woman goes off birth control pills.

How do I treat Melasma?

How can I tell which form of Melasma I have?

There are four types of melasma pigmentation patterns: epidermal, dermal, mixed, and an unnamed type found in dark-pigmented skin. Epidermal melasma is identified by the presence of excess melanin in the superficial layers of skin. Dermal melasma is distinguished by the presence of melanophages where cells ingest melanin throughout the skin. Mixed melasma includes both the epidermal and dermal forms of melasma. The fourth or 'unnamed' form of melasma has excess melanocytes present in the skin of dark-skinned individuals.

Melasma is readily diagnosed by recognizing the typical appearance of brown skin patches on the face. Dermatologists are physicians who specialize in skin disorders and often diagnose melasma by visually examining the skin. A black light or Wood's light can assist in diagnosing melasma, although is not essential for diagnosis. In most cases, mixed melasma is diagnosed, which means the discoloration is due to pigment in the dermis and epidermis. Rarely, a skin biopsy may be necessary to help exclude other causes of this local skin hyperpigmentation.


What treatments does Dermatology Associates offer for melasma?

Hydroquinone: This medicine is a common first treatment for melasma. It is applied to the skin and works by lightening the skin. You will find hydroquinone in medicine that comes as a cream, lotion, gel, or liquid. You can get some of these without a prescription. These products contain less hydroquinone than a product that your dermatologist can prescribe.
Tretinoin and Corticosteroids: To enhance skin lightening, your dermatologist may prescribe a second medicine. This medicine may be tretinoin or a corticosteroid. Sometimes a medicine contains 3 medicines (hydroquinone, tretinoin, and a corticosteroid) in 1 cream. This is often called a triple cream.
Topical Medicines Your dermatologist may prescribe azelaic acid or kojic acid to help lighten melasma.
Procedures: If medicine you apply to your skin does not get rid of your melasma, a procedure may succeed. Procedures for melasma include a chemical peel, microdermabrasion, dermabrasion, laser treatment, or a light-based procedure. At DAS our preferred treatment is the skin brightening peel. It is painless, works relatively well, has minimal downtime, and has no risk of worsening melasma which can happen with laser treatments. Only a dermatologist should perform these procedures.

What solution is best for my skin condition?

Under our board-certified dermatologist’s care, many people with melasma have a good outcome. Melasma can be stubborn, though. It may take a few months of treatment to see improvement. It is important to follow our provider’s advice to ensure that you get the most benefit from treatment. It also can help avoid skin irritation and other side effects. After your melasma clears, you may need to keep treating your skin. Your dermatologist may call this maintenance therapy. Maintenance therapy can prevent melasma from returning. Our board-certified dermatologists will also give you specific care on how to detour future outbreaks of melasma. Make an appointment today with one of our board-certified dermatologists.


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