Most people want smooth, unblemished skin. Melasma can get in the way of that. Its appearance on the face can make you self-conscious and be hard to conceal, even with quality make-up. However, there are treatment options. Learn the basics of melasma and what you can do to regain your even-toned complexion.
Melasma, or hyperpigmentation, is a common condition characterized by the appearance of tan, brown or gray patches of skin on the face. These patches are caused by the overproduction of melanocytes, or color-producing cells in the skin. Melasma spots are usually found on the forehead, cheeks, bridge of the nose, upper lip and chin. Women are more likely to develop melasma, especially during pregnancy (called chloasma, or “the mask of pregnancy) or other hormonal shifts that happen when taking oral contraceptives or hormone replacement medications. People with darker skin also have a greater likelihood for having hyperpigmentation, as do those with a family history of melasma. The top trigger for melasma is sun damage from exposure to ultraviolet light from the sun. Many people find that their melasma is more pronounced in the summer when their exposure to the sun increases.
The first line of defense against melasma is to avoid sun exposure. Make sure you are wearing a daily, broad spectrum sunscreen with an SPF of 30 or above. A “physical sunscreen” that contains zinc oxide or titanium dioxide is best. If you are going to be in the sun for a while, wear a broad-brimmed hat, sunglasses, and other protective clothing. These measures will not only keep your melasma from being triggered, but will also prevent more serious skin issues, like skin cancer.
Creams, gels, liquids and serums that you can apply to your skin are the next step in helping your hyperpigmentation to fade. The most common topical medication is hydroquinone, which lightens your skin. You can get over-the-counter products with hydroquinone, but medications prescribed by a dermatologist will have higher concentrations of hydroquinone. Your doctor may also prescribe corticosteroids and/or tretinoin. Certain products, called a triple cream, have all 3 medications in them. Topical treatments may also contain antioxidants, salicylic acid, azelaic acid or kojic acid to help even skin tone.
Lasers have been shown to be successful in reducing the brown spots of melasma. Non-ablative lasers, like Fraxel, target 20%-40% of the skin, heating up the lower layers of skin and causing micro-injuries. The skin responds by producing new and healthy skin cells and collagen, which is the primary protein in your body, responsible for providing strength and structure to your tissues. Nonablative lasers don’t remove top layers of skin, so there is almost no downtime.
Chemical peels remove the top layers of skin, causing skin cell turnover so that your skin is left smoother and more evenly toned. Light and medium chemical peels are what is recommended for melasma. In both types, an acid is applied to your skin and left on for a period of time. Your doctor will then neutralize the acid, clean the skin and apply moisturizer and sunscreen. For 2-4 days, your skin will probably be red and peel, as it exfoliates and new skin grows. If you get a light peel, you may want to get a series of peels until you reach your desired lightening of hyperpigmentation. A chemical peels can also be a wrinkle reducer, smooth scarring and treat skin conditions like acne and rosacea.
Like a chemical peel, microdermabrasion is an exfoliating treatment that removes the top layers of damaged skin cells. The removed skin cells are vacuumed up with the exfoliating device. Microdermabrasion is a good option for those with mild melasma looking for a gentle treatment that requires no recovery or downtime.
If you have discolored spots on your face, visit a dermatologist to determine if you have melasma. Other skin conditions can look like melasma, so it’s a good idea to have a professional diagnose the cause of your pigmentation issues. Your dermatologist may use a device called a Wood’s light to see how deep your melasma has penetrated your skin. If a different skin condition is suspected, your dermatologist might perform a biopsy in the office, removing a small section of skin to be sent to a lab. Once melasma has been diagnosed, you can work with your dermatologist to create a treatment plan that will give you the best results and fit in your budget.
Get in touch with Vanguard Dermatology today. With locations throughout the greater New York City area, Vanguard has numerous board-certified dermatologists who can provide expert guidance and treatment for your skin care needs.