Melasma: On a regular day, do you know the number of people you see or just pass by? It is difficult to comprehend the number because there are so many. Each person you get a glimpse of, is different in some way or the other. Many times, if you are not able to remember the name of a person, you remember a distinguished feature he or she has, such as colour of hair, blue or green eyes, different skin colour, patches on the skin or even sharp or long nose. These features are in no way harmful, but often they tend to affect your social life to some extent and in turn affects your self confidence or self esteem.
For example, if you have seen someone with dark or discoloured patches on the skin or even if you have it, often people might make fun of it or laugh at you. Even though the condition does not harm your health, it harms your mind.
Melasma is the condition which causes dark and discoloured patches on your skin and this condition affects women more than men.
What causes Melasma?
Melasma is an acquired pigmentary disorder characterized by symmetric dark brown or black macules on the face. What causes Melasma, is not completely clear. However it occurs due to various factors such as genetic predisposition, ultraviolet radiation, hormonal factors and drugs.
What this exactly means is that birth control pills, pregnancy, and hormone therapy, all of them can trigger the condition of melasma. Many a times, stress and also thyroid disease might be some of the other causes of melasma. People with darker skin are more at risk to get Melasma compared to those with fair skin.
Role of sun protection in Melasma
One of the most important and common causes of the condition of Melasma is continued and excessive exposure to the ultraviolet rays of the sun. It is very important that whenever you are going out during the day, to make sure you protect yourself from the Sun at all or most of the time.
Any kind of sunscreen which is SPF 30 or higher is effective from the harmful rays of the Sun. Specially during swims or any kind of outdoor activity. Applying sunscreen every 2 hours increases its effectiveness against the rays.
How do you know if you have Melasma?
The condition of melasma causes patches of discoloration. The patches of skin are darker than the usual skin color. Typically the discoloration occurs on the face and is symmetrical, with matching marks on both sides of the face.
Brownish colored patches are seen on:
- Cheeks
- Forehead
- Bridge of the nose
- Chin
The skin discoloration doesn’t do any kind of physical harm, but you might feel self-conscious.
If you notice these symptoms of melasma, visit us at Ambrosia Clinic and we will do our best in making sure that your melasma can be kept a check on.
Management of Melasma:
Topical Creams:
Hydroquinone is considered gold standard treatment for Melasma. It is used at a concentration of 2-4%. Prolonged use of hydroquinone is not advisable as it often causes Ochronosis.
Hydroquinone efficacy is enhanced when used in a combination with other topical agents and is usually combined with Kojic Acit, Vitamin C, Arbutin and Tretinoin.
Tranexamic Acid – This inhibits ultraviolet induced plasmin activity which directly inhibits melanin activity. Tranexamic acid can be used topically by an intradermal micro injection or it can also be taken orally.
Various other topical medications which can be used but have varied results are Resorcinol, Flavonoids, Licorice, Kojic Acid and Glycolic Acid.
Chemical Peels For Melasma
Chemical peeling is the application of a chemical agent to the skin, which causes the controlled destruction of a part of your superficial skin, leading to the exfoliation and removal of superficial lesions, followed by the regeneration of new superficial skin. Chemical peels are a well-known modality of treatment for the condition of melasma. 
The basic mechanism of these chemical peels for melasma, is the removal of unwanted melanin. Chemical peels have proven to be useful agents for melasma both as a sole treatment as well as in combination with other topical creams. Glycolic acid, Salicylic acid, Jessners solution, Tretinoin, Phenol, Lactic acid, Kojic acid, Trichloroacetic acid are the ingredients used in the peels depending on the type of skin colour and pigmentation.
Lasers
Laser and light therapy is an alternative third-line approach to treat melasma and might be particularly beneficial for patients who are not responding to topical creams and chemical peeling treatment, or when a patient wishes for an accelerated pace of improvement. It is important to note that laser and light based treatment have the potential to speed up the removal of melasma, but they are not known to cure melasma. Furthermore, they present a risk of a melasma flare.
Do’s and Don’ts for Melasma-
DO’s
Always apply sunscreen
One of the most important things to prevent Melasma is use a sunscreen that protects against UVA and UVB rays AND VISIBLE LIGHT. You should always use a sunscreen that is a broad-spectrum, and apply it every 3 hours.
Don’ts
Spending too much time in Saunas does not help.
Many studies have shown that any kind of heat can cause your skin to produce extra pigment, due the overproduction of melanocytes. If you are suffering with Melasma, it is best to stay out of steams and saunas.
Homemade remedies does not help.
Many people might mentioned that home remedies might be an effective solution for treating problems like dry skin or acne but you should be very careful when using these remedies for the condition of Melasma. Melasma is a highly specific and rather complicated skin condition, hence it is best you consult your doctor or us before taking the treatment in your own hands.
Also Read: WHY DOES PIGMENTATION HAPPEN? AND DIFFERENT TYPES OF PIGMENTATION?
About The Doctor:
Dr. Sindhuri Reddy specializes in clinical and cosmetic dermatology and dermatosurgery. Her continuous thrive to be updated in recent advances of skincare gives her a unique insight and approach to skincare. She has an MBBS and MD from NTR University of Health sciences and has done observership at Mayo Clinic, USA . She has several academic publications to her credit. Her areas of special interest are acne scars, hair transplantations and lasers.
