Melasma

Melasma is a common hyperpigmentation disorder that causes brown patches and spots primarily on the skin of the face.

There are different types of melasma, depending on what skin layer it affects.

• Epidermal melasma – the most superficial type with an increase in the skin pigment (melanin) in the top layer of skin (epidermis).
• Dermal melasma – an increase in skin pigment occurs in the deeper layer of the skin (the dermis).
• Mixed melasma – a combination of epidermal and dermal melasma.

While melasma isn’t painful and doesn’t present any health risks, it may make you feel self-conscious and is therefore often treated for cosmetic reasons.

What are the symptoms of melasma?

Melasma causes dark patches of the skin.  Typical symptoms of melasma include:

• Patches that are darker than your usual skin colour. People with darker skin types may notice bluish-grey patches.
• Patches are often symmetrical (i.e., patches develop on both sides of the face)
• Can be more noticeable in certain areas, especially forehead and over cheekbones.
• Depending on the type of melasma you may also notice an increase in blood vessels.

What can trigger melasma?

Melasma can be triggered by a number of factors including sun exposure, pregnancy, hormones, some medications and stress.  It may have a genetic component, as it often runs in families and is usually more common in women.

How is melasma treated?

Melasma can be a difficult form of pigmentation to treat, but there has been some success using topical lightening creams, some of which are only available after seeing a doctor.  Treatment with laser and/or chemical peels may also be helpful depending on the type of melasma. Avoiding the sun and diligent use of broad-spectrum sunscreen is a vital part of managing melasma.

What about skin care?

A strict sunscreen regimen is essential in the management of melasma.  Always look for sunscreen that protects from both UVA and UVB (broad-spectrum) rays.  Physical (mineral) sunscreens with zinc oxide or titanium oxide are typically best.   Your clinician will recommend additional skin care products most beneficial for your individual needs.

Long-term management

Unfortunately, there is no cure for melasma so it will require ongoing maintenance.  Diligent use of sunscreen, practicing sun safety and avoiding the sun as much as possible are the most important things you can do to minimise melasma.  Ongoing use of topical products may be necessary.  Maintenance laser and/or chemical peel treatments may also be recommended.