Melasma Treatment: Causes, Symptoms, Types, Procedure & Prevention

Melasma is a skin disease that leads to the appearance of flat brownish or blue-grey patches on the skin, especially on the face. It affects adults and is a more common complaint among women than men. Chloasma, or mask of pregnancy, is another name for melasma. Sun exposure is a common risk factor. Melasma is a chronic pigmentary disorder that waxes and wanes but often remains resistant to treatment.

Melasma occurs most commonly on the face, including:

• Cheeks
• Forehead
• Bridge of nose
• Chin

Apart from the face, it rarely involves the exposed skin of the forearms, neck and back.

Dermatologists categorise the types of melasma based on the depth of the skin discolouration:

• Epidermal Melasma: The melanin deposit in the topmost layer of skin, i.e., the epidermis, leads to dark brown patches with well-defined borders. This superficial type of melasma responds best to treatment.
• Dermal Melasma: The pigment build-up in the dermis, the deeper layer of skin, is not easily accessible. It leads to the appearance of light brown or bluish-grey diffused patches that respond poorly to treatment.
• Mixed Melasma: This pigmentary concern causes different colour patches in the epidermis and dermis. This is the most common type of melasma, and the treatment response usually varies depending on the amount and location of the melanin build-up.

The signs and symptoms of melasma include:

• Freckle-like spots
• Flat patches of brown, blue or grey colour
• Defined or diffused patches

The patches usually occur symmetrically on the cheeks, forehead, nose, chin and jawline.

Here are two primary causes of melasma:

• Sun/UV Exposure: Exposure to UV radiation from the sun or laptop/TV screens can trigger excess melanin production in the skin. It can worsen melasma if present or cause recurrence after treatment.
• Hormonal Imbalances: Dermatologists often correlate melasma cases with estrogen and progesterone sensitivity. Melasma is significantly more common in pregnant women and those using high-dose hormonal contraceptive pills. Hormonal changes during menopause or conditions like hypothyroidism can often cause or worsen melasma.

Apart from these, a few other factors may trigger melasma:

• Family History: Those with a positive history of melasma in the family have a higher risk than others.
• Skin Colour: People with dark skin are more likely to develop melasma than those who are fairer.
• Chemical-based Skin Care Products: Skin-care products with fragrances and chemicals that cause skin irritation can trigger melasma.

Dermatologists at Oliva diagnose melasma by clinically examining the discoloured skin.

They may use Wood’s lamp method to observe the skin under blue light to identify the pigmentation level. In exceptional cases, they may perform a biopsy in the affected area to confirm the diagnosis under a microscope.

Although many advanced treatments are available, the response of melasma to treatments remains variable. No single treatment option can ensure total and permanent relief from melasma.

At Oliva, your doctor will customise your treatment and recommend regular maintenance to reduce melasma and prevent a recurrence. She may recommend any of the following options as standalone or combo treatment based on the type, cause and severity of your skin condition:

• Topical or Oral Medications: Medications, especially topical creams, are often the first line of treatment and an essential part of post-care. It may include:

1. 1. Hydroquinone: Your dermatologist at Oliva may recommend hydroquinone with a concentration of 2-4% as the primary treatment for melasma. She may advise you to apply it at night on the patches for 3-4 months. Prolonged use may aggravate pigmentation.
   2. Retinoids: Medical experts often use tretinoin in conjunction with hydroquinone or other bleaching agents at night to boost the results of melasma treatment.
   3. Bleaching Agents: Skin lightening agents like kojic acid, azelaic acid, glycolic acid, arbutin and Vitamin C can reduce melanin synthesis and help lighten the pigmented patches. Your doctor may add it to your post-care regimen as long-term maintenance therapy to minimise the chances of the recurrence of melasma.
   4. Tranexamic Acid: A newer molecule used in oral, injectable or topical form by leading dermatologists for treating melasma is quite effective and may be a part of a combination treatment.
   5. Hormonal Medications: Your dermatologist may assess your hormonal health and advise you to discontinue any medication that may induce melasma.

• Advanced Procedural Treatments: Here are some in-clinic treatments that your dermatologist at Oliva may recommend for attaining visible results of melasma treatment.

1. 1. Chemical Peels: The application of different concentrations of natural extracts like glycolic acid and kojic acid on the discoloured skin for controlled exfoliation of top layers inhibits melanin formation. It is most effective in reducing epidermal melasma. However, you may need multiple sessions of chemical peel treatment at regular intervals of a few weeks to attain visible results.
      Watch this video and find out about the chemical peel procedure at Oliva:
   2. Laser Treatment: Dermatologists at Oliva undergo rigorous training to use the latest USFDA-approved Q-switched Nd:YAG laser technology and treat deeper melasma that does not respond to topical medication and peel treatment. The laser beam penetrates the deeper layers to break down the excess melanin without adversely affecting the surrounding skin. However, the precise treatment may require multiple sessions based on the type and severity of your skin condition to provide the best results and for regular maintenance.
      You can opt for laser treatment at Oliva after watching this video by our expert dermatologist:

   Remember, preventing exposure to UV rays is the most crucial step in treating melasma, as even mild sun damage can increase, trigger or cause recurrence. It is mandatory to use sun protection with every treatment modality.

Unfortunately, there is no sure-shot way to prevent melasma altogether. However, the following measures can reduce the risk of melasma and recurrence:

• Avoid Excessive Sun Exposure: Do not go out during peak sunlight hours or use protective gear like scarves, sunglasses and umbrellas to prevent melasma and other forms of sun damage to the skin.
• Regular Use Of Sunscreen: Use sunscreen with SPF 30 or above recommended by your dermatologist 15-20 minutes before going out in the sun. Reapply every three hours to prevent melasma and lighten existing pigmentary conditions.
• Healthy Diet And Skin-Care Habits: A nutrient-rich diet with vitamin D and regular skin-care helps to keep the skin healthy and protect it from multiple disorders, including discolouration.
• Judicious Use Of Hormonal Pills And Contraceptives: Consult a doctor to avoid indiscriminate use of hormonal pills if you have a positive family history of melasma.

Here are the top reasons to choose Oliva for melasma treatment:

• Largest team of over 100+ experienced dermatologists with unmatched expertise in providing holistic treatments customised to cater to your unique skin and hair needs
• Latest USFDA-approved Q-switched Nd:YAG laser technology is available in-house for safe and effective non-surgical melasma treatment
• Stringent protocols and world-class service for the excellent quality of care
• Nationwide presence with modern, state-of-the-art facilities prioritising client safety and comfort at all costs
• An outstanding 91% rating voted by over 6,00,000 satisfied clients during 14 years of service
• The No.1 Skin & Hair Clinic in the country, according to The Times of India

If you think you have melasma, then don’t wait any longer!
Fill out the Book Appointment form and our customer care will get help you get a consultation with our expert skin doctors. You can also call us on 📞82978 82978 and book an appointment at a time, date and location convenient for you.