Melasma occurs when the pigment producing cells of the skin, called melanocytes, begin to produce too much pigment. This leads to the development of large tan to brown patches on the skin. It may appear on the cheeks, cheek bones, chin, nose, forehead, above the eyebrows, and/or the upper lip. Occasionally in patients with significant UV exposure, melasma will appear on the forearms and neck. Melasma occurs in all skin tones, but is more common in patients with darker skin tones. Melasma can be more common in some families.
Sun exposure and increased amounts of female hormones can worsen melasma. Heat, severe skin dryness, some cosmetics, and inflammation are other precipitating factors.
Melasma lasts decades, so patients will need a treatment plan that is life long. Treatment often begins with a skin care regimen composed of a daily sunscreen, moisturizers and skin care brightners. Some of the more common skin brightners include hydroquinone, vitamin C, azelaic acid, tretinoin and kojic acid.
For patients who don’t see improvement of their melasma with a skin care regimen alone, procedures may be added. These include superficial chemical peels, microdermabrasion and/or lasers. Lasers should be used with care in patients with darker skin tones by an experienced laser surgeon.
Melasma is a delicate condition and patients often have flares throughout their lifetime. Your ASDS physician will be there to care for you and your skin throughout your life.