What Is Melasma?
Melasma is a condition in which areas of the skin become darker than the surrounding skin. Doctors call this hyper-pigmentation. It typically occurs on the face, particularly the forehead, cheeks and above the upper lip. The dark patches often appear on both sides of the face in a nearly identical pattern. The darker-colored patches of skin can be any shade, from tan to deep brown. Rarely, these dark patches may appear on other sun-exposed areas of the body.
Causes of Melasma
- UV light: This pigmentation is light sensitive and UV exposure plays a significant role in causing the pigmentation.
- Hormones: This is very common in women during periods of hormonal changes especially pregnancy. Women who are on hormone tablets like the contraceptive pill or hormone replacement after menopause are also prone to develop this pigmentation.
- Genes:If the mother suffers from this form of pigmentation, it increases the child’s chances of pigmentation.
- Diet:Sometimes a low level of vitamin D or zinc may predispose one to get this pigmentation.
Prevention for Melasma
- Sunscreen use: Using a sunscreen regularly may help prevent it. At the very minimum it will reduce the spread of the pigmentation and make it less dark and deep. It is advisable that all of us should use a sunscreen of SPF30 about 15-20 minutes before sun exposure. If staying outdoors for prolonged periods, then it is advisable to reapply the sunscreen every 2-3 hours. This becomes even more important during pregnancy and especially if your mother has melasma.
- Avoid Hormone supplements: If you have a high risk of melasma or already have some facial pigmentation, this should be considered before starting the pill. Talk to your gynecologist and look for an alternative contraceptive.
- Diet: A diet which is rich in anti-oxidants (all your brightly coloured fruits and vegetables) helps maintain the health of your skin and reduce pigmentation.
4. Early check: If you do develop some pigmentation, it is advisable to see your doctor at the earliest. The doctor may recommend some blood tests like the test for thyroid function. If this is the problem, then early treatment may help minimize the pigmentation.
- Medicated creams: There are many creams which can be prescribed by the doctor. They usually are labelled as skin brightening creams or skin whitening creams. They contain one or more of hydroquinone, kojic acid, retinol, alpha hydroxyl acids, beta hydroxyl acids, tetrahydrocurcumin, mulberry extracts, licorice to name just a few. Using these creams in isolation or in combination with treatment procedures can help reduce the darkness and extent of the pigmentation.
Some people may not respond to the first or even the second cream but almost everyone responds to some cream or the other. It is worthwhile to try the creams regularly. It is also important to use the creams regularly (over months to years). There may be no improvement in a couple of weeks- the secret to success is in persisting with the treatment.
As hormones stabilize, the dark patches of melasma usually fade. Women who develop melasma as a result of pregnancy often see the patches fade months after the baby is born. Women who take oral contraceptives or hormone replacement therapy often see the patches fade once they stop taking the medications.
A few options may help fade or treat dark patches:
- Hydroquinone is a cream that takes pigment out of the skin. It blocks the natural chemical process that leads to the creation of melanin, the substance that makes skin dark.
- Tretinoin is a type of vitamin A that helps to increase the rate at which dead skin cells fall off and new ones appear. This makes the melasma patch fade more quickly as the pigmented cells are shed.
- Chemical Peels are liquid solutions applied to the skin to provide a mild chemical burn, similar to sunburn. Over time, the burned layers peel off, leaving fresh, new skin. Chemical peels vary in strength. Glycolic acid is among the mildest, and therefore has a lower risk of causing scarring or skin discoloration. Chemical peels may be used if melasma does not respond to other treatments.
- Intense Pulsed Light therapy utilizes certain wave lengths of light to target and remove pigmented areas of skin.
However, be careful as the last two treatments, although effective, can actually worsen the melasma if not done by an experienced physician.