By intern Jack P. and Dr Arron
Melasma is a common skin condition that causes patches of discoloration, most commonly on the face. It occurs when melanocytes, the skin cells responsible for producing pigment, become overactive and produce excess melanin. It is especially common and can be more noticeable in individuals with darker skin tones.
Melasma can be unpredictable, with periodic flares of skin darkening. There is rarely one single cause, instead, various factors can contribute to the development or worsening of pigmentation.
Common triggers include:
- Sunlight, UV, and and visible light exposure
- Heat or infrared radiation
- Hormonal changes
- Skin irritation or inflammation
- Genetics
What can we do about it?
Melasma is a chronic condition that can be managed, but may recur. Treatment focuses on reducing existing pigment while also preventing melanocytes from being triggered again.
No treatment will work without sun protection, so daily sunscreen use is essential. SPF30+ should be applied before sun exposure, with reapplication every 2 hours. Tinted sunscreen can provide further protection from visible light, which can be especially beneficial for darker skin.
What treatments are available at PAD?
Melasma responds best to a combination of treatments, which may include:
- Topicals: hydroquinone, azelaic acid, retinoids, steroids, tranexamic acid, vitamin C, and other brightening agents
- Chemical peels: helps to improve superficial pigment and assist in skin turnover
- Laser/light treatments: can target pigment, but must be used selectively, as excess heat and inflammation can worsen melasma. Treatments must be chosen carefully in darker skin tones, because excessive irritation can cause additional pigmentation.
Which treatment is right for me?
There is no single best treatment for melasma. Treatment plans can look vastly different depending on the patient. Skin tone, pigment depth, hormones, triggers, and previous treatments can all affect how individuals respond.
At Premier Aesthetic Dermatology, both Dr. Arron and Dr. Jhin take an individualized approach to treatment. The goal is not to use the strongest treatment, but to safely improve existing pigmentation without triggering another flare in the process.
