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Melasma – Types, Causes, Symptoms, Treatments and Prevention Tips

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    Women take many measures to keep their skin blemish-free. But, many times, the situation is out of their control and the skin on their face can develop various issues such as pigmentation, spots, etc. One such skin affliction is melasma. It is a highly noticeable pigmentation issue and requires specialized attention for the successful lightening of dark patches. Let us understand melasma and its causes and treatment better.

    What Is Melasma?

    Melasma is a hyperpigmentation skin concern of the face, which means that excess melanin is produced in the facial skin. This leads to the formation of discolored patches that are brown to grey and are conspicuous on the face. Melasma on the face can cause a significant impact on one’s self-confidence and should be treated appropriately.

    Must Read: What Is The Best Treatment For Pigmentation?

    What Are The Types Of Melasma?

    Depending on the depth of the pigmentation, melasma is categorized into the following types

    1. Epidermal Melasma: Present in the top layers of the skin in the form of dark brown patches, epidermal melasma responds the best to treatment as well. The patches have a well-defined border.
    2. Dermal Melasma: This type of melasma reaches the dermis, and the patches appear a lighter brown (or even bluish) than the epidermal type. These patches do not have defined borders and can be difficult to treat.
    3. Mixed Melasma: When both the epidermal and dermal types of melasma are present, it is referred to as mixed type melasma. Dark brown, light brown, and bluish patches are interspersed on the affected skin. This is the most treatable form of melasma.

    Who Gets Melasma?

    About 90% of people who are affected by melasma are women, with pregnant women being the most susceptible to get it. The age group it normally affects is between 20 years to 50 years. Melasma is rarely seen in men.

    Signs And Symptoms Of Melasma

    The signs and symptoms of melasma include –

    • Freckle like spots
    • Flat, brown patches
    • Patches with either defined borders or irregular borders

    These patches can form different patterns on the face and usually are present on the forehead, cheeks, nose, upper lips, and jawline.

    Must Read: How To Remove Pigmentation On Face?

    What Causes Melasma?

    Melasma causes are complicated as there are many factors including genetics that can trigger the overproduction of melanin by the melanocytes and cause the formation of melasma patches. Here are the factors that are known to play a role in causing melasma

    • Hormonal Imbalances: An imbalance in different hormones can impact melanin production and cause melasma. Such a hormonal imbalance can be caused due to pregnancy, menopause, oral contraceptive pills, etc. Melasma after pregnancy can also occur as a result.
    • Sun Exposure: We are all well aware of how the sun’s rays can darken our complexion. They are also responsible for triggering the dark patches seen on the face due to melasma.
    • Scented Soaps And Deodorant: In a few cases, an irritation caused by the ingredients of scented soaps and deodorant can also increase melanin production in the skin.
    • Hypothyroidism: The lack of a sufficient amount of the thyroid hormone can impact the melanocytes and lead to melasma patches to form on the cheeks, nose, etc.
    • People With Darker Skin: Such people are known to have a higher predisposition to develop melasma because of the already increased production of melanin in their skin.
    • Those With A Family History: A genetic predisposition is responsible for more than one-third of melasma cases in women.

    How Is Melasma Diagnosed?

    A qualified and experienced dermatologist can diagnose melasma by simply examining the skin. He/she may or may not use a black light or a Wood’s lamp to know the depth of the pigmentation. In rare cases, the doctor might suggest getting a skin biopsy, in case they suspect the presence of any other hyperpigmentation concern and for differential diagnosis. Mixed melasma is the most common type of melasma diagnosed.

    What Is The Treatment For Melasma?

    Depending on the depth of the patches and the trigger factors, melasma treatment is recommended by dermatologists. Commonly used techniques to get rid of melasma are given below –

    • Chemical Peel: For melasma that is superficial and hasn’t penetrated into the deep dermis layers, chemical peels can be used. These contain facial acids that are safe to use on the skin for easy and efficient exfoliation of the damaged skin layers. elasma might not go away completely with treatment, but a modest degree of skin lightening can be achieved.
    • Laser Treatment: Q-switched Nd:YAG laser is the epitome of technologies when it comes to melasma laser treatment. The laser light targets and destroys the melanin in the melasma patches and does not cause any damage to the surrounding skin. Once the melanin is destroyed, the skin starts to lighten, and within a few sessions, you will notice a vast difference in the dark patches on your face. This procedure provides a permanent cure for melasma.
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    • Microdermabrasion: This is another treatment that can remove the darkened skin, but it does so by exfoliating the skin using a diamond-tip device.
    • Discontinue Hormonal Contraception: When the hormonal imbalance created by contraceptive pills is causing melasma, it is best to discontinue them and look for other contraception options. Once you stop ingesting the pills, the melasma will lighten to a reasonable extent.
    • Topical Bleaching Creams: Various topical creams are available in the market and are prescribed by dermatologists to bleach the skin and lighten the dark patches eventually. These often contain ingredients like azelaic acid, ascorbic acid, and kojic acid. They work by using different mechanisms to stop melanin synthesis and lighten the skin.
    • Hydroquinone: This is most popularly used topical medication for melasma treatment. A 2% to 4% concentration cream is prescribed by dermatologists to be applied on the melasma affected skin at night. The course of the treatment using this is usually between two to four months, depending on the skin is responding to the cream. Prolonged usage is not recommended for hydroquinone as it can cause contact dermatitis. This method for treating melasma should only be performed under medical supervision.
    • Retinoids: These are topical creams that can lighten the melasma patches, but the concentration of the retinoid should only be determined by a certified dermatologist after examining your skin. These creams can cause contact dermatitis and are safest under medical supervision. An example for a retinoid used as a melasma cure is tretinoin.
    • Intense Pulsed Light (IPL): Light of different wavelengths are projected on the melasma affected skin that targets the melanin and lightens the skin in the process. The use of different wavelengths helps to target melasma at both superficial and deeper levels. IPL can be used to treat moderate to severe melasma as well.

    A single melasma cure does not exist. In most cases, a combination of various therapies is utilized to lighten the melasma patches.

    Must Read: Permanent Skin Whitening Treatments

    Melasma Treatment Before And After Results

    How To Prevent Melasma?

    Melasma can become permanent if you do not take the right measures to prevent it from forming or re-occurring in the future. Here are some tips for you –

    1. Stay Out Of The Sun: The UV rays from the sun are a vital trigger factor for melasma as they can increase melanin production on continuous exposure. This can be easily prevented by staying indoors as much as possible. Avoid sun exposure between 10 am and 3 pm as sun rays are their strongest intensity then.
    2. Always Apply Sun Screen: Apart from staying out of the sun, apply a sunscreen with SPF 30-50 for your melasma prone skin to protect it from both UVA and UVB rays. Opt for products that contain zinc oxide or titanium dioxide.
    3. Melasma Diet: Eating a well-balanced diet can go a long way in maintaining your skin in optimum health and preventing any skin conditions like melasma from developing easily. Vitamins, minerals, and healthy fats need to be present in ideal amounts in your diet. If you feel the melasma diet you are eating is lacking in any way, ask your dermatologist to recommend you a multivitamin supplement or individual supplements.

    Must Read: How To Remove Sun Tan From Face?

    Melasma affects many women in India, but it can be tackled easily. You do not have suffer from how the dark patches are marring your look anymore. There are plenty of treatments available that work towards effective lightening and removal of melasma patches. Make sure to speak to an experienced dermatologist and get the best advice.

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    About The Author

    Kushneet Kukreja

    Kushneet Kukreja

    A postgraduate in Biotechnology from Kingston University and an ISSA Certified Specialist in Fitness & Nutrition, Kushneet Kukreja is a passionate writer who works in close association with the dermatologists at our head office to generate valuable and scientifically accurate content for our blog.

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