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What to do When the Diagnosis is Melasma

Posted by Suzzy on 6/25/2018 to Skin Problems

If a doctor has diagnosed your skin condition as melasma, you likely have questions about it, including: What is it?; Who is prone to it?; What are my treatment options?; How do I manage it?; and, What are my treatment outcomes? Read on to get your questions answered.

What is Melasma?

Melasma is a common skin problem that causes brown to grayish brown patches on the face. Most people diagnosed with melasma see its effects on their cheeks, the bridge of their nose, forehead, chin, or upper lip. Melasma can also appear on your forearms and neck and any other areas commonly exposed to the sun. Beyond skin discoloration, symptoms are non-existent. Melasma will not make you sick and the patches of skin will not be sore to the touch.

How is it Diagnosed?

A doctor can diagnose melasma just by looking at your skin. He or she will use a lamp called Wood’s Light. This light emits ultraviolet rays. The lamp lets the physician see the patterns and depth of skin discoloration. The doctor will ask for your medical history because it will help determine what may have caused the disease.

Melasma can look like other skin conditions, so to rule out other ailments, your dermatologist may perform a biopsy. A biopsy is the removal of a small piece of skin and can be done right in the doctor’s office. The biopsy is then reviewed by lab personnel to make sure it is not another more serious skin condition.

What Causes Melasma?

The cause of melasma is not yet clear but it likely occurs when color-making cells, called melanocytes, produce too much color. People with darker skin pigmentation are more prone to melasma than those with lighter skin because they have more active melanocytes.

Sun exposure can cause melasma. Ultraviolet (UV) rays from the sun stimulate melanocytes. Even limited sun exposure can cause melasma to return after it has faded. Melasma can often get worse during the summer because we tend to be outside more when it’s warm and sunny. To avoid getting melasma repeatedly, it’s a good idea to avoid prolonged sun exposure.

A change in hormones can affect melasma, which is why pregnant women often get the disease. Melasma is called ‘chloasma’ or ‘the mask of pregnancy’ when it appears during gestation. Other common causes include birth control pills, hormone replacement therapies, and some skin care products that create irritation in the skin.

Who is Prone to Melasma? 

Women are more likely than men to get melasma. In fact, only 10% of people who get melasma are men. People of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent are more likely to get melasma, as these nationalities tend to have darker skin. If you have a blood relative diagnosed with melasma, you have a greater chance of being diagnosed with the disease as well.

What are Your Treatment Options? 

Melasma can fade on its own. If your melasma was diagnosed while you were expecting, the melasma will likely diminish after you deliver your baby. If you take birth control pills or hormone replacement therapy and stop, melasma may fade as well. If the melasma does not go away or you want to keep taking birth control pills, treatments for melasma are available. These include:

·         Hydroquinone: Hydroquinone is a medicine used as a first treatment for melasma. Once applied topically, Hydroquinone lightens the skin by whitening the upper layers of the epidermis. Hydroquinone takes the forms of a cream, lotion, gel, or liquid. Some Hydroquinone containing products are available without a prescription and contain less of the active ingredient than a product your dermatologist can prescribe.

·         Arbutin: This beta-D-glucopyranoside natural form of hydroquinone is a naturally occurring plant product which has been used successfully in the treatment of melasma. Arbutin acts by inhibiting tyrosinase, which in turn decreases melanin formation. Given the risks associated with Hydropquininone, most experts recommend a natural form called Alpha Aburtin which works just ask well without the serious, long-term, negative side effects.

·         Tretinoin and corticosteroids: Your dermatologist may prescribe a skin lightening cream. This topical cream may be tretinoin or a corticosteroid. Some medicines contain three ingredients to help lighten your skin, including hydroquinone, tretinoin, and a corticosteroid. If it has these three ingredients, it is called a triple cream.

·         Kojic acid: Kojic acid is a natural substance found in mushrooms. The acid has antibacterial and antifungal properties and is used in skin creams because it has skin lightening properties. Kojic acid works by preventing the production of melanin, a skin pigment that causes age spots; however, melanin is also the natural pigment that gives color to our skin. The acid stops the production of melanin in the top layers of the skin. The result is lighter skin. Although the skin remains discolored in the lower layers, a cream containing kojic acid helps improve this discoloration.

·         Procedures: If a topical medicine does not get rid of your melasma, a procedure may be necessary. Chemical peels, microdermabrasion, and dermabrasion are viable options for reducing the appearance of melasma. To be safe, only a dermatologist should perform these procedures because new skin problems may occur if the treatment is not specific to your skin type.

How Can You Manage Melasma? 

Since exposure to the sun can cause melasma to reoccur, it’s imperative you wear sunscreen to protect yourself from the sun’s UV rays. Dermatologists recommend wearing sunscreen every day, not just during the summer months. UV rays can penetrate through clouds; as such, it is important to apply sunscreen even on cloudy days.

When purchasing a
sunscreen, check to be sure it offers broad-spectrum protection. This means it will protect against UVA and UVB rays. Also check the sun protection factor (SPF) to ensure that it is at least 30. Finally, quality sunscreens should also contain zinc oxide or titanium oxide to block the sun’s harmful rays.

The discoloration melasma causes should fade once you take the necessary precautions regarding the sun or once your hormones return to normal after pregnancy or medication. If the discolored patches still bother you, use make up to even out your skin tone or consider whitening cream.

Flawless Beauty and Skin has a treatment set available for those who have been diagnosed with melasma. The Professional Hyperpigmentation Treatment Set contains all the products you need to address melasma.

Melasma is a common diagnosis. If you have been diagnosed with melasma, we want to hear your story! Tell us how you were diagnosed, how you treat it, how you prevent outbreaks, and how you use your experience to help others. Submit your story to our blog at

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