Melasma is a hyperpigmentation disorder that causes patches and spots, usually on the face which are darker than your natural skin tone. It appears more commonly on cheeks, forehead, chin and upper lips and less commonly on other body parts like arms, neck and back.
Melasma occurs predominantly {around 90%} in female population than in male population, although, it can occur in any skin type but it is more common in medium to dark brown skin tone that is common in Asian, Middle eastern and Brazilian population.
Causes
Excessive sun exposure is one of the important causes of melasma because ultra violet rays affect the cells that control melanin, that is the reason melasma increases in the summer months. Another important cause of melasma is pregnancy.
When it occurs in pregnancy it is called “chloasma’ or mask of pregnancy. Also taking birth control pills and thyroid diseases are also thought to cause melasma because of the hormonal changes, predominantly progesterone and vitamin D levels. Stress and certain medications {phototoxic drugs} like certainantibiotics, NSAIDS, retinoids, hypoglycemic and antipsychotics are also thought to cause melasma.
Treatment of melasma:
For some women melasma disappears on its own after pregnancy orafter women stop taking oral contraceptives. Certain medications like hydroquinone, steroids, vitamin A derivatives prescribed by healthcare professional can control melasma. Chemical peels derma and micro derma abrasion, and micro needling by a certified medical professional are considered to be the best possible options with least side effects. These treatments strip away the top layer of skin of help lightening the dark patches.
Psychological impact of melasma is important while considering the treatment plan as it can cause anxiety, depression, low self-esteem, and poor body image. A proper counselling of the patients is a must while delivering the care and the patient has to understand that treatment of melasma is not an overnight process and single sitting treatment is not going to cure it all. Many patients do not have a self-confidence because of this disease.
Lasers can be used in selected patients with resistant melasma after proper counseling and conducting test treatments. Low-fluence Q switched Nd-YAG lasers seem best option for refractory cases of melasma, especially in the individuals with darker skin tones. High energy laser treatments like non-ablative or ablative fractional lasers, IPL or high energy Q switched laser treatments should be avoided at all costs, as they can actually exacerbate melasma and cause hypopigmentation in darker skin types.Combination therapies show much promising results.
Most of the treatment options available will fade melasma with time but there is no definitive treatment. There are certain skin care regimes a patient must follow for longer lasting results like double cleansing the skin every night, always using sunscreen above 30 SPF and follow up visits after treatment.
There are also certain home remedies which are used to lighten the melasma like using aloe vera , tranexamic acid, topical kojic acid, and glutathione therapy.
Patience is very important for every treatment of disease. Also visiting a certified healthcare professional and seeking the complete information about the condition isnecessary.
Dr Mehreen Riyaz Kokiloo, Cosmetic Dentist and Medical Cosmetologist Co Sparkle Healthcare, Bund side kursooRajbagh
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.