Melasma

What is Melasma?

Melasma is a common skin problem that causes brown patches on the face.  Most commonly found on the cheeks, forehead, chin, and upper lip.  Melasma can last for years and potentially may never go away. It is more common in women and is can be triggered by pregnancy (15% to 50% of pregnant women) or birth control pills.  Additionally, darker skin individuals and those with a family history are more likely to have melasma.

Types of Melasma:

There are three types and they are determined by the depth of the pigment.  Your dermatologist can help distinguish amongst them.

  • Epidermal: Epidermal Melasma affects the top layer of skin.  It tends to be a brown pigmentation with defined borders.
  • Dermal: Dermal Melasma affects the skin deeper.  Unlike epidermal, it can take longer to respond to treatments.
  • Mixed: Mixed Melasma is when epidermal and dermal are both present.

Melasma Treatments:

Melasma can fade over time on its own. his typically happens if pregnancy or birth control were the cause.  If it lasts for longer periods of time there are a variety of treatments.  These include:

  • Sunscreen and sun protection.  UV and even visible light stimulate the production of extra pigment.  Effective sun protection is critical to treating melasma.
  • Topical lightening agents.  There are a variety of medicines and topical creams that will help slow the production of pigment and enhance clearance of the pigment that is already there in excess.  
  • Combination creams:  Special, custom blends of ingredients can speed the clearing of pigment.  
  • Retinoids (Retin A and others):  Tretinoin helps normalize the production of pigment and enhances the sloughing of extra pigment.
  • Chemical Peels:  Topical regimens combined with a series of chemical peels can greatly enhance the reduction in pigment darkness.
  • Lasers:  Sometimes laser and Intense Pulsed Light can be a valuable adjunct to the treatment of pigment. Lasers do not treat melasma well on their own but can nonetheless be used to enhance the overall cosmetic effect. 
  • Oral medications:  There are a few oral supplements/treatments that can be used to treat melasma.

Your dermatologist will be able to recommend the best treatment for your melasma.  If you notice any skin irritation, darkening of the skin, or any other problems during treatment, please call your dermatologist.