Melasma

It is a facial skin condition where the skin becomes patchy brown, tan, or blue-gray discoloration. The common facial patterns in melasma are centrofacial (center of the face), malar (cheekbones), and mandibular (jawbone).
Discoloration or hyperpigmentation primarily on the face are characteristics of Melasma. It is commonly called a butterfly rash.

Prevalence of Melasma

Melasma is seen in both men and women between 20 to 50 years of age but has a higher predilection for women. Melasma is seen on upper lip, forehead, upper cheeks and chin as well.

Causes of Melasma
  • Primarily related to sun exposure.
  • Hormonal changes (like Postmenopausal women, Pregnancy, etc).
  • Exposure to heat ( Like while cooking, etc)
  • Genetic: Higher incidences of melasma are seen in women of Latin and Asian descents and People with olive or darker skin like Asian, Hispanic, and Middle Eastern individuals.
    Family history also is a cause.
  • Certain medicines like OCP’s.                                                   
  • Products or treatments that irritate the skin may cause an increase in melanin production by the skin, leading to Melasma. 
Prevention of Melasma
  • Facial sun protection and avoiding exposure to excessive heat is a primary thing to be practiced for preventing Melasma.
  • Avoiding melasma triggering medications.
Treatment of Melasma
  • Topicals:
  1. Sunscreen has to be applied on a regular basis.
  2. Depigmenting medications.
  3. Most popularly formulated depigmentation creams contain Hydroquinone, Azelaic acid, Retinoic acid, Phenolic hyperpigmenting agent, Kojic acid and nonphenolic bleaching agents. This has to be taken only on doctor recommendation and supervision.
  • Microdermabrasion: An abrasive material like fine diamond chips or aluminum oxide crystals is used in combination with a vacuum to stimulate the top layers of the skin to exfoliate. These sessions are done over a few minutes to an hour.
  • Lasers: Laser treatments will help in reducing the pigmentation. This happens in multiple sessions.
  • Chemical peels: Depigmenting chemicals are applied to the affected area. This gradually clears the pigmentation in a couple of days.

# Disclaimer: Melasma treatment results are highly variable from Patient to a patient and sometimes even after the complete treatment melasma can reoccur.

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