San Diego Melasma Treatment

Melasma is a disorder of pigmentation that most commonly afflicts women during the reproductive years (90% of all cases) and presents with brown patches on the face. The brown pigmentation most commonly occurs on the cheeks, around the eyes, the bridge of the nose and forehead. The disease has a predilection for darker-skinned individuals, particularly Hispanics, Asians and individuals from the Middle East and northern Africa.

What causes melasma?

People with a family history of melasma are more likely to develop melasma the condition. A change in hormonal levels may cause melasma. For example, use of birth control may trigger melasma. The term chloasma or the “mask of pregnancy” is melasma that occurs with pregnancy. Hormone replacement therapy after menopause has not been shown to cause the condition.

Other factors that can worsen melasma include:

  • Sun exposure: ultraviolet light can stimulate the pigment-producing cells of the skin to produce pigment.
  • Irritation of the skin.
  • Exposure to warm environments.
  • Photosensitizing medications

Will my melasma go away on its own?

It is impossible to predict whether melasma will spontaneously resolve, how long it will remain or whether the melasma may worsen over time. The pigmentation may fade or disappear after pregnancy, but often it remains for years or may worsen with time and continued sun exposure

How is it treated?

  • Sun protection and the use of broad-spectrum sunscreens which protect against UVA and UVB radiation are essential in the treatment of melasma. A sunscreen with SPF 30 or higher should be selected. Sunscreens should be worn daily, whether or not it is sunny outside, or if you are outdoors or indoors. A significant amount of incidental sun exposure occurs while driving in cars, running errands and sitting near windows.
  • The mainstay of melasma treatment is topical depigmenting agents. Hydroquinone is the most common “bleaching” agent. Hydroquinone works to inhibit tyrosinase, an enzyme required to produce melanin pigment in the skin.
  • Other treatments, often used in combination with hydroquinone to achieve better results, include:
  • Tretinoin cream
  • Topical corticosteroids
  • Azelaic acid
  • Salicylic acid
  • Glycolic acid
  • Kojic acid
  • Laser and light therapies

In general, melasma is difficult to treat. Even successfully treated melasma will recur upon re-exposure to sunlight. With use of the appropriate protective measures against sun exposure, as well as the application of hydroquinone and other adjunctive treatments, significant improvement in melasma can be achieved.