Melasma

Melasma is a painless skin condition characterized by brown and grayish patches that appear on the forehead, cheeks, bridge of the nose, chin or upper lip. These patches can also appear on the forearms or other parts of the body exposed to the sun in rare cases.  Sun exposure triggers melasma.

Women are far more likely than men to get melasma.  Melasma is so common among expectant mothers that it has been given its own name, “chloasma,” or “the mask of pregnancy.” Having a darker skin tone or a blood relative who had the condition increases the chance of having melasma.

Q: What causes melasma?

A: Although the cause is unknown, we do know that it occurs when melanocytes, the skin cells responsible for producing color, become hyperactive. People who have darker colored skin are more likely to have melasma because they have more melanocytes than those with fairer complexions. 

Q: What causes those melanocytes to become over-productive?

A: There are two typical triggers: sun exposure and hormones. Ultraviolet rays (UV) stimulate the melanocytes. In fact, even after melasma fades, exposure to just a small amount of UV light can cause it to return. Hormones, the other culprit, seem to stimulate melasma during times of significant fluctuation. Pregnancy, birth control pills, and hormone replacement therapy (HRT) can all trigger melasma.

Q: How is melasma treated?

A: Sometimes, the melasma goes away on its own. This is especially likely when the melasma is attributable to pregnancy. As soon as the woman gives birth, the melasma is likely to fade. If birth control pills or hormonal therapy is the suspected problem, the melasma should start to go away once they are discontinued.

If the melasma does not resolve itself or continuance of birth control pills or other hormonal therapy is desired, the first line of treatment is proper sunscreen and then a hydroquinone cream, gel, or liquid. This topical medicine works by gradually lightening the skin. Other topical medications, such as kojic acid, are also an option. Alternatively, eMatrix Sublative rejuvenation and/or chemical peels can also be used to remove these patches of pigmentation.