All You Need to Know About Melasma
Our skin is always changing and evolving. One day you can wake up with perfectly clear skin, while on other days you notice several spots have appeared overnight. One cause behind such spots is melasma, a cosmetic skin condition that most often appears on the face, forehead, upper lips, cheeks, and the nose bridge.
What is Melasma?
Melasma is a type of hyperpigmentation caused by increased melanin production. The cause of melasma is unknown, but it’s thought that genetics, hormones, and sun exposure all contribute to its development.
It most often affects women but can also affect men. Melasma commonly occurs around puberty, and the severity differs from person to person. It is common in people with thyroid disorders.
Typically, melasma creates irregular patches of pigmented skin, with the appearance of tan, brown, and reddish-brown areas. There can also be unpigmented patches that appear darker than the surrounding pigmented skin.
Signs and Symptoms of Melasma
The first thing to check for is excess pigment (the dark patches). Some people experience as many as 10 to 15 blemishes, while others will have fewer. The color of melasma can differ from purple to brown, while some patients show multiple shades.
Melasma is diagnosed with a simple skin examination by a qualified dermatologist. A special lamp called a Wood’s lamp uses ultraviolet light that allows the examiner to see the extent of the pigmentation more easily. Alternatively, dermoscope, a handheld lens with 20x magnification helps delineate the extent and severity of melasma.
In rare cases, a dermatologist might take a tissue sample from the lesions using a small scalpel. They will then perform a biopsy to tell for certain if it’s melasma or some other skin condition causing hyperpigmentation.
When you know the reason behind your blemishes, you can then ask about an appropriate face pigmentation treatment to reduce their severity.
Risk Factors for Melasma
Some people will have a greater risk of developing melasma than others, but there are conditions that may increase your chances of developing the skin condition.
Sun Exposure: Excessive sun exposure may exacerbate melasma. Covering up with sun appropriate clothing and wearing excellent quality sunscreen will help.
Birth Control Pills: These can increase levels of estrogen and progesterone, which can trigger melasma.
Pregnancy: Elevated levels of estrogen, progesterone, and melanocyte stimulating hormones (MSH) during the second and third trimesters can trigger increased melanin production by melanocytes.
Hormone Replacement Therapy (HRT): Postmenopausal women receiving HRT are more susceptible to melasma.
Thyroid Disease: Patients with thyroid disease have an increased risk of developing melasma.
Genetic Predisposition: A family history of melasma could make you more prone to the condition.
Skin Color: Dark skin is more susceptible to developing melasma. Interestingly, the incidence of melasma is higher in people with skin types III-VI, which are most common in India, China, the United States, and Southeast Asia.
Medications: Some medicines can increase the risk of melasma, including anti-seizure medication. The medicine makes skin more sensitive to UV, which triggers over-production of melanin.
People who work in a hot area, such as cooks, or steelworkers, are at higher risk. The heat irritates the skin and triggers melanin production.
Skin Care Products: Some skin care products can irritate and inflame the skin, leading to an increase in melanin production. Avoid perfumed products that your skin may be sensitive to.
Stress: Research reveals a link between stress and excessive production of MSH that creates conditions conducive to melasma.
Mental Coping with Melasma
The patchy light to dark brown skin discoloration of melasma is like a mask over your true appearance. It’s not a life-threatening condition, but it can cause a loss of confidence and self-esteem. As a result, the condition can cause a significant reduction in quality of life.
Adding to the mental coping challenge is the fact that melasma often strikes when women are already dealing with a lot, such as pregnancy, and menopause.
These two life stages involve significant hormonal changes that can trigger undesirable symptoms such as mood swings, sleeping problems, and fatigue. Adding facial blemishes to the equation will only intensify emotional trauma and anxiety.
Understanding the condition and the causes of melasma is a good first step to reducing your stress about the strange new blemishes that have suddenly appeared on your face. It will also help to know that there are melasma treatments available that will lessen the severity of melasma.
Melasma Lifestyle Modifications: Is Melasma Treatable or Not?
Unfortunately, there is no cure for melasma. However, treatments are available to lessen its appearance, and there may also be a few lifestyle changes you can make that could help.
We don’t know of any foods or drinks that will stop melasma, but many dermatologists say skin-friendly nutrition, such as foods rich in vitamin D, can stop it from worsening. Add foods and drinks rich in vitamin D to your diet, like:
- Orange juice
- Oily Fish
- Almond Milk
You may also consider taking a vitamin D supplement. Your healthcare provider can measure vitamin D levels, so you can know if you are getting enough.
As sunlight can trigger melasma, ensuring your skin is protected from the sun is another straightforward lifestyle choice you can make. Apply good quality broad spectrum sunscreen, and wear sun protective clothing, such as a wide brimmed hat and sunglasses. Ensure you carry a tube of sunscreen with you so you can reapply it every couple of hours. Sun protection, even when indoors, is ideal for people with melasma.
Many of the skincare products you are currently using could be irritating your skin and exacerbating your melasma. Choose fragrance-free products and stop using them at the first sign of irritation.
Don’t wax any areas of your body with melasma. Waxing irritates the skin, which can trigger melanin production. Your dermatologist can recommend suitable types of hair removal treatments that will be right for your skin type.
Melasma Treatment with Home Based Care
Melasma triggered by birth control pills is likely to disappear once you stop taking them. If your blemishes are caused by pregnancy, they should fade after the baby is born. However, it is not possible to treat melasma at home with DIYs.
Glutathione is an antioxidant containing three amino acids that most mammals have: cysteine, glycine, and glutamic. A 2017 review [*1] revealed that glutathione taken in oral form reduced melanin production in participants with melasma, while those who took a placebo saw no such improvement.
First line treatments can start at home using lotions, creams, gels, and liquids. The most common topical agents prescribed include ingredients like hydroquinone, azelaic acid, kojic acid, topical steroids, retinoids, arbutin, and mequinol.
One of the most widely used melasma and best cream treatments is a triple combination of hydroquinone, corticosteroids, and retinoic acid.
Melasma Treated by Chemical Peel
A chemical peel is another treatment often recommended for reducing the appearance of melasma. Chemical peels are a procedure that removes the outermost layer of skin via controlled destruction through chemical means. The skin then starts the healing process to create a new blemish-free epidermis.
A variety of chemical peels in varying strengths and applications are available. Which one you should use will come down to your skin type, skin color, and the skin layer where the pigmentation has developed. Compounds used in a chemical peel may include:
- Glycolic Acid
- Salicylic Acid
- Trichloroacetic Acid
- Melasma Treatment by Laser
Without a cure, melasma laser treatments are proving to be highly successful at treating the condition and reducing the appearance of unwanted skin pigmentation. A topical treatment is often used in conjunction with laser treatment to improve results.
Laser treatments are not overly painful. The treatment is often compared to a rubber band snapping across the skin, or a tiny prick at most. The treatment is made more comfortable by applying a topical numbing agent.
Most patients will notice improvements in their melasma after about three treatments at three to four weekly intervals, but the severity of your condition will determine how many treatments you will need.
Melasma Reduction by Medifacials
A medifacial is a treatment your dermatologist can use to reduce the appearance of melasma and can take a variety of different forms, including hydrafacials, skin lightening, and microdermabrasion.
A Hydrafacial is a multistep treatment involving exfoliation, cleansing, and extraction while injecting a range of pigmentation-targeting serums into the skin.
Mesotherapy delivers skin lightning agents like tranexamic acid and glutathione deep into the skin’s layers where they can achieve the best results.
If you are concerned about melasma and would like to know more about your treatment options, call Sarin Skin, your dermatology experts in Delhi. Together, we can reduce the influence melasma has on your life and provide expert advice on how you can complement your clinical treatments at home with the best melasma creams for your skin type. Call today to find out more.