What Is Melasma?

Melasma is a common skin problem that manifests as brown spots on the face. Medically termed as hyperpigmentation, the condition is symmetrical and affects women much more commonly than men. When melasma occurs in pregnant women, which it often does, it also goes by the moniker of chloasma, or the “mask of pregnancy.”

What causes brown spots on the face? The exact cause of melasma is unknown. The brown spots on the face are attributed to an increase in the amount of a skin pigment called melanin. The pigment may be located superficially, deeply, or a combination of both in the skin. Melasma can be readily diagnosed by a medical practitioner recognizing the typical appearance of brown spots on the face.

It is believed that the hyperpigmentation of melasma could be triggered by several factors, including:

  • Excessive sun exposure
  • Pregnancy
  • Birth control pills
  • Hormone replacement therapy
  • Family history of the condition
  • Anti-seizure medication
  • Stress
  • Thyroid disease

Is Melasma Curable?

Although melasma is not a threat to your health, it can have a considerable psychological impact. While it can be difficult to treat and may clear spontaneously without treatment, melasma may clear with the consistent use of sunscreen and strict sun avoidance. For some women, the discoloration of melasma may disappear after giving birth or if birth control pills and HRT are discontinued. Because melasma can have a significant emotional effect, you may opt for hyperpigmentation treatment.

What Treatment Options Are Available for Melasma?

Management and treatment of melasma can be challenging and may require long-term treatment with topical agents. First and foremost, sun exposure must be minimized, and consistent use of sunscreen is advised. The overall goal of hyperpigmentation treatment is to lighten the brown spots on the face, which is the mechanism of the majority of the topical agents. The topical treatment of melasma may include hydroquinone, azelaic acid, kojic acid, tretinoin (Retin-A™), steroids, glycolic acid, and newer hydroquinone derivatives such as mequinol and arbutin. As far as topical agents, hydroquinone has remained the “gold standard,” or most effective treatment for melasma. You may require a combination of hyperpigmentation treatments consisting of triple therapy with hydroquinone, Retin-A, and a topical steroid cream.

Sometimes the results of topical hyperpigmentation treatment are unsatisfactory and they may even cause significant side effects. If this is the case, other possible options for the treatment of melasma include chemical peels, dermabrasion, and microdermabrasion. As of late, melasma laser treatment with BroadBand Light (BBL™), also known as Intense Pulsed Light (IPL™), and skin resurfacing with the Halo™ laser have been gaining popularity.

What Can Patients Expect During the Procedure? Are There Any Side Effects?

Before undertaking hyperpigmentation treatment, you should be realistic as these procedures don’t guarantee that melasma won’t come back, and some cases of melasma can’t be completely lightened. Additionally, melasma treatment is a slow process, usually taking several months or more, especially if using topical agents.

Chemical peels utilize acids, such as alpha hydroxy or beta hydroxy acids, to peel away the outermost layers of the skin, which contain the pigment responsible for melasma, and improves skin coloration. Common side effects of chemical peels include temporary skin irritation, flaking, and redness. Depending on the depth of the peel, there is no to minimal downtime (0 to 3–7 days).

BBL uses light energy to gently heat the outer layers of the skin. The energy is absorbed by the melanin-producing cells (melanocytes) of the skin to kill the cells and decrease the levels of melanin in the skin. In other words, your skin lightens. This melasma laser treatment is safe and virtually pain-free with minimal to no downtime. Common side effects of BBL include skin redness and a sunburn-like sensation, all of which subside fairly quickly. Results can be noticeable after several days but peak in a week or two after the treatment.

Treating brown spots on the face with the Halo skin resurfacing system is unique, because it utilizes two types of lasers that target two of the three layers of the skin. This is important in hyperpigmentation treatment, as melasma can reside superficially, deeply, or a combination of the two in the skin. In other words, the Halo system allows customizable melasma laser treatment. The procedure is minimally painful––a topical numbing cream prior to the procedure and built-in cooling technology adds to your comfort. The procedure takes 20 to 30 minutes to complete and there is minimal downtime (a few days). Possible side effects of melasma treatment via Halo include temporary swelling, redness, and peeling of the skin, all of which typically resolve in a week.

If you are plagued by melasma and want to get rid of or lighten those brown spots on your face, contact Precision M.D. today to schedule a free consultation.