Melasma Treatment: Procedure, Cost And Results

Melasma is a skin condition characterised by flat brownish or bluish grey patches on the skin, especially on the face. While the primary causes are genetics and hormonal fluctuations, sun exposure can aggravate it further

Hyperpigmentation is the broad classification of skin discolouration, and it can include acne spots, post-inflammatory hyperpigmentation, freckles, age spots, sun spots, tan, and melasma. Melasma is one kind of hyperpigmentation and requires expert diagnosis and treatment.

The most common areas where melasma develops include, the cheeks, chin, forehead, nose, and the area above the upper lip.

In rare cases, some people may develop melasma on their jawline, necks and arms too.

How can you identify melasma? Only a qualified dermatologist can confirm it, but melasma usually appears as patchy discolouration, spots and freckles. The colour gradient varies for everyone based on the person’s natural skin tone. It ranges from different shades of brown to bluish-grey.

Here are some signs that your skin discolouration may be melasma:

• The first noticeable sign is that the patches and the spots are darker than your natural skin tone.
• Melasma usually appears on both sides of the face.
• Compared to other kinds of hyperpigmentation, melasma covers significant areas of the skin.
• It also has the tendency to appear unevenly. For example, it can be darker than others areas on the skin. Sun exposure may result in melasma like this.
• Melasma also becomes more prominent when you spend time in the sun.
• Though less common, people with light skin and men, too, can develop melasma.

Whenever you see the signs, please make sure that you consult a dermatologist.

Dark-skinned people are more prone to melasma as their skin tans easily.  This skin condition is more common among women (20-40 age groups) during pregnancy and is also known as the mask of pregnancy. Hormonal fluctuations can also cause melasma. Rarely, it also occurs among men.

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

1. Epidermal Melasma: The melanin deposit in the topmost layer of skin, i.e., the epidermis, leads to dark brown patches with well-defined borders. Its appearance is prominent under the Wood Lamp. In a dermascan, it shows up as clusters of brown web-like patterns with dark specks. This superficial type of melasma responds best to treatment.
2. Dermal Melasma: The pigment build-up in the dermis, the deeper layer of skin, and is not well defined. It appears in light brown to blue-grey shades. Unlike epidermal melasma, it does not become more prominent under the Wood Lamp, while under a dermascan it shows up as a meshy, network –like formation, and you will notice tiny, widened blood vessels. This type of melasma responds poorly to any of the treatments.
3. Mixed Melasma: This is the most common type and appears in bluish or greyish colours and in mixed patterns when you see through a Wood Lamp or a dermascan. With treatment, you can see partial improvement.

1. Genetics

   This is a primary factor, where studies show that the family members of almost 50% of people with melasma also have the condition.

2. Excessive Exposure To UV Rays

   This can stimulate melanocytes in the skin to produce more melanin, causing melasma.   

3. Pregnancy And Other Hormonal Conditions

   Increased levels of estrogen and progesterone contribute to the appearance of melasma. If you are not pregnant, but you have hormonal fluctuations, it can lead to melasma. An underactive thyroid results in a condition called hypothyroidism, which also causes melasma.

4. Hormonal Therapies

   If you are taking any medications to change your hormonal condition, make sure that you are under medical supervision. Hormonal disruptions can affect melanin production and may result in melasma. Birth control pills are one example.

5. Certain cosmetics And Phototoxic Drugs

   Certain medications, including antibiotics, antipsychotics, anti-seizure medications, retinoids, diuretics etc make you sensitive to the sun, thus vulnerable to melasma. Some cosmetics can also be phototoxic.

6. Tanning Beds

   Tanning beds produce excessive UV light, which damages your skin to a large extent. It also worsens your melasma.

No studies show that certain foods or drinks contribute to melasma. However, foods rich in vitamin D, like almond milk, eggs, meat, mushrooms, oily fish, orange juice, and yogurt, can improve overall skin health.

Oliva’s dermatologists can take a look at your skin and diagnose melasma. To identify the depth of your melasma, which is critical, they use a specialised device known as the Wood’s lamp or a dermascope. It helps them customise a treatment plan. In some people, melasma can resemble other skin conditions. To rule this out, our doctors may perform a biopsy in the affected area.

While several advanced treatments are available for melasma, the results vary for every individual. Further, no single treatment can ensure total and permanent results.

Oliva’s dermatologists will customise your treatment plan along with maintenance sessions to prevent recurrence. She may recommend one or more of the following options based on the underlying cause, the type and the severity of your melasma:

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. Hydroquinone: Our doctor 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 at night in conjunction with hydroquinone or other bleaching agents 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: Our dermatologists use this newer molecule in oral, injectable, or topical form to treat melasma. It is quite effective and may be part of a combination treatment.
5. Hormonal Medications: The dermatologist will assess your hormonal health and decide if you should continue or stop any hormonal medications.

Advanced Medical Melasma Treatments: Here are some in-clinic treatments that your dermatologist at Oliva may recommend to achieve visible results of melasma treatment.

1. Chemical Peels: Applying different concentrations of natural extracts like glycolic acid and kojic acid on the discoloured skin for controlled exfoliation of top layers inhibits melanin formation. Chemical peels are the 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 are best known for performing laser treatment for melasma. They 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.

The cost of melasma treatment in India can vary widely depending on the type of treatment, the clinic’s location, and the dermatologist’s expertise. Here is a general breakdown of the cost of different melasma treatments:

Topical Treatments:

Over-the-counter creams: ₹200 to ₹1,500 per month

Prescription creams: ₹500 to ₹3,000 per month

Chemical Peels:

Single session: ₹4,500 to ₹6,000

Multiple sessions (3-6 sessions): ₹12,000 to ₹25,000

Laser Treatments:

Single session: ₹9,000 to ₹12,000

Multiple sessions (3-6 sessions): ₹23,000 to ₹40,000

Note: The prices mentioned above are general estimates and can vary based on the severity of the condition, the area to be treated, and the number of sessions required. It’s important to know these potential variations and consult a dermatologist for a detailed treatment plan and cost estimate tailored to your specific needs.

Preventing melasma altogether may be difficult, but here are some ways to make it less evident and stop it from worsening:

1. Do Not Skip Sun Protection: Avoid sun exposure during the peak hours unless absolutely necessary for you to step out, as it triggers melasma. Pick a water-resistant, broad-spectrum sunscreen with SPF 30 or more and apply it on all exposed parts every day. Re-apply at least once every 3 hours.
   Stay in the shade as much as you can and also use scarves, sunglasses, and umbrellas to protect yourself. There are now hats available with UV protection, see if you can get one of those.
2. Build A Holistic Lifestyle: If you have melasma or not, make sure you have nutrient-rich meals, sleep well and be physically active. This will also help maintain your hormonal health. Have enough water and avoid aerated drinks with empty calories, as they can affect your skin health.
3. Choose Gentle And Appropriate Skincare Products: There are numerous products available in the market. Skin care trends are also plenty. Make sure that you pick products that suit your skin type and address your concerns, rather than going with products that are popular. Consulting a dermatologist to select the products that work for you can help.
4. Use Make-Up Wisely: If you have the habit of using make-up products, then there are several tricks and tips to cover up uneven skin tone. Try them. (Please note that this is only a suggestion for those who like to use make-up products. While this is an option, don’t hesitate to consult an experienced dermatologist to treat the root cause of your melasma.)
5. Use Medication Only Under Supervision: Avoid the use of medications that can affect your hormones unless there is medical supervision as indiscriminate use can affect your hormonal health negatively.  

If you think you have melasma, then don’t wait any longer!

Fill out the Book Appointment form or call us on 📞82978 82978 to book an appointment at a time, date and location convenient for you.