Melasma is a form of hyperpigmentation that is very common among Asians. It is also known as the ‘mask of pregnancy’.
It appears as dark, often symmetrical , blotchy patches on the upper cheek, forehead, nose and lips. It can also appear on the neck, chest and even forearm.
Although melasma can affect both men and women, it is way more common in women. Onset can be as earlier as 20 year of age, and it does continue to affect people 60s and beyond.
What causes melasma?
In melasma, there is increased activity of melanocytes, which are cells in our body that produces pigment.
The exact cause is unknown and is though to be multifactorial in nature. Listed below are some of the known predisposing factors for developing melasma;
- Family history of melasma
- Asian Skin Type
- Sun exposure
- Child bearing age
- Increased exposure to female hormones such as use of oral contraceptive pills or hormone replacement pills
How should melasma be treated?
1. Firstly, get the correct diagnosis.
Other pigmentary disorders like freckles, solar lentingies, post inflammatory hyperpigmentation may be mistaken for melasma. An experience physician would be able to diagnose melasma from physical examination alone.
2. Secondly, reduce all risk factors as much as possible!
Sunscreen is of utmost importance! A broad spectrum suncreen, one that blocks both UVA and UVB should be used. SPF should be at least 50 and frequent reapplication, as often as every 2-3 hours, is a must.
Try Healthsprings Sunblock SPF50: It contains non-greasy formulation especially for oily or combination skin — helps protect against skin darkening, pigmentation and premature skin ageing and wrinkles.
Hormonal factors also play a part in melasma formation. If melasma is brought about by use of oral contraceptive pills, those pills have to be stopped and alternative mode of contraception sought.
3. Thirdly, use proven treatments like topicals containing hydroxyquinone, retinoids and mild corticosteroids.
Other agents that can be added include Kojic acid, Azelaic acid, Vitamin C and Arbutin.
Can lasers be used for melasma?
Lasers are considered second line for treatment of melasma. Situations whereby lasers can be used include:
- Concomittant pigmentary disorders amenable to laser treatment
2. Recalcitrant melasma, where the melasma is responding poorly to treatments mentioned above after 6-8 weeks of therapy.
Melasma is a complex condition and there is essentially no cure for it. However, it is still possible to improve the condition or improve the appearance, if one remains compliant to his/her physician instructions and reduce all risk factors as far as possible.