One great indicator of having an undamaged skin is it's being smooth and blemish free. Yes, your face may not be plagued by dreadful acne, but that alone cannot guarantee that your skin is 100% healthy.
The presence of dark spots and uneven skin tone, despite the absence of pimples and other impurities, is a sign of unhealthy skin.
Skin discolouration is caused by excess production of pigments, otherwise known as melanin. Skin conditions that are caused by pigmentation come in different colours and forms. An example of which are freckles, sunspots, Hori’s Nevus, post-inflammatory hyperpigmentation, and melasma. Among these, we will be having a closer look at Melasma.
Definition of Melasma
Melasma or ‘chloasma’ is a skin condition brought about by pigmentation that usually affects adults. It can be distinguished from other skin pigmentation flaws by its shape and colour. Brown and grey coloured irregularly shaped patches characterize melasma. It is prevalent among people with medium to dark skin tones or those whose skin tan easily.
Studies show that melasma is more prominent in people living in Asia and the Middle East.
Which parts of the body does Melasma affect?
Melasma affects certain parts of the body that are always exposed to the sun. Patches may form on the face, specifically on the cheeks, chin, forehead, upper lip, and nose. It can also be seen on the neck or forearms.
What causes Melasma?
There are several factors that can be attributed to the existence of melasma, but the precise cause of this condition remains unknown. The most common reasons for developing melasma are credited to hormones and ultraviolet (UV) rays from the sun, phototherapy, or sun-beds. On some occasions, cosmetic products or medications that irritate the skin may also trigger melasma.
Melasma generally affects women and is seen less in men. Women who undergo pregnancy or are taking contraceptive pills have a larger chance of getting melasma. It is believed that the changes in hormones cause the pigmentation to overly produce. Melasma that affects pregnant women is coined as “pregnancy mask.”
Is Melasma contagious or hereditary?
Melasma is not contagious. It is not hereditary, although it can be present in several members of a family that has a history of this skin condition.
How do I know if I have melasma and not some other skin pigmentation flaw?
The best way to have your skin flaw diagnosed is by consulting with a dermatologist. Doctors can distinguish melasma from other hyperpigmentation just by looking at your skin. However, to get an accurate diagnosis and rule out other symptoms that may be similar to it, a test may be requested by the doctor to be done. A small part of the skin may be extracted as a sample for further examination (biopsy).
Other skin assessment tools, such as the Wood’s lamp and the Melasma Area and Severity Index (MASI) can also be used to evaluate the severity and degree of melasma.
What are the kinds of Melasma?
Melasma has different levels of severity. It is categorized into three kinds:
Epidermal melasma affects only the very top portion of the skin’s surface. Patches of discolouration are well defined and easier to banish. Melasma that affects the dermal layer of the skin is more difficult to treat because of the existence of melanophages (melanin-ingesting cells). Dermal melasma are embedded deeply into the skin and can be determined by brown or greyish colour. Its shape is less defined as compared to melasma found on the epidermal layer. Mixed melasma is comprised of both epidermal and dermal kinds occurring on the skin.
Is Melasma temporary or permanent?
Depending on the cause, melasma may either be temporary or permanent. For excess pigmentation triggered by pregnancy or contraceptives, melasma may vanish naturally upon giving birth or cessation of the use of the prescribed medication that affects the hormones. In addition, women affected with melasma during pregnancy can expect it to recur with every child conception.
Melasma that is caused by extreme sun exposure may or may not disappear completely. However, there are several treatments available that can aid in improving this skin condition.
Can Melasma be prevented?
Avoiding specific triggers can prevent melasma that is due to sun exposure and birth control pills or contraceptives.
Whenever outdoors, be sure to protect all exposed skin against UV rays with a generous application of sunscreen, ideally above SPF 30. Umbrellas and wide-brimmed hats also come in handy.
What are the treatments available to get rid of Melasma?
Fortunately, there are several treatments available that patients can turn to as remedies to melasma:
- Cosmetic makeup or skin camouflage. Cosmetic makeup that is tinted can be used to cover up melasma. A skin camouflage is a thick cream that is matched to the patient’s skin colour. When applied to the affected area, the camouflage is not easily erased. This kind of treatment does not diminish melasma, but helps in improving the quality of life of people affected by melasma.
- Dermatological procedures. Aesthetic advancements continue to develop more, especially with procedures that aim to enhance skin and restore its health. The following are treatments that offer improvements for melasma sufferers:
- Chemical peels – Chemical peels work by applying concentrated chemical agents like glycolic, lactic or salicylic acid on the surface of the skin. The chemicals exfoliate the outermost layer of the skin, which results to peeling and improvement of skin pigmentation as the skin is renewed. An experienced doctor must administer chemical peels, as mishandling of the substance may cause more harm than good on a patient’s current condition.
- Microneedling – Microneedling works by poking tiny needles into the skin in repetition to aid lightening creams in reaching the depth of the skin.
- Lasers – Lasers use energy charged light beams that either destroy pigments or removes the surface of the skin that is affected by melasma.
Note that these procedures are prone to risks and side effects. Some of which are bruising, irritation, infections, swelling, and scarring.
- Topical lightening creams. Topical creams like hydroquinone, retinoid, and steroid can help lighten the discolouration of the skin brought about by melasma. The application of these creams must follow the doctor’s orders as they can cause side effects when administered incorrectly. Pregnant women are advised to stay away from using hydroquinone or retinoid creams during the course of their pregnancy as these may hurt the fetus.
Which of the treatments available is best to address Melasma?
Each treatment has its pros and cons. It is highly recommended for individuals suffering from melasma to get a professional consultation with a reputable medical practitioner in order to get proper diagnosis and treatment apt for the degree and severity of melasma present on the skin.
Among the three, laser treatments have a greater success rate in achieving quick results. However, this may still require several sessions, especially for extreme cases of melasma.
What are the factors to consider when searching for the right doctor to treat melasma?
Extensive research is recommended when choosing a dermatologist to handle your case of melasma. Seek also for recommendations from family or friends that may have undertaken treatments for melasma. In addition, patients need to ensure that the dermatologist handling their cases has the proper training and skills to perform any kind of procedure to treat melasma.