What is melasma?
Melasma is a common skin condition that primarily affects women. It causes blotchy patches of hyperpigmented skin that appear as tan or dark discolorations on the cheeks, nose, forehead, chin, and upper lip. However, it can appear on any area that is frequently exposed to the sun including the forearms and neck. Melasma develops over time and is more common in people of color and people with a family history of melasma.
The only symptom is discoloration. It is common in women during pregnancy and has been called “the mask of pregnancy” because hormones increase during pregnancy. However, melasma can affect women of all ages and can last for years or decades and can negatively affect a woman’s self-image, self-esteem and confidence.
What causes Melasma?
The cause of melasma is unclear, but sun exposure and fluctuations in hormone levels activate the skin cells, called melanocytes, to produce excess melanin, the substance that gives skin its color. People of color are more prone to melasma because they have more active melanocytes than people with light skin. Melasma often runs in families.
Common melasma triggers include:
- Ultraviolet (UV) light from the sun is a huge trigger and can aggravate underlying causes like hormonal changes. Even a short exposure to the sun’s light and heat can worsen existing melasma and cause it to return after treatment.
- Hormone fluctuations common during pregnancy, oral contraceptives or hormone replacement therapy are known to cause melasma.
How is melasma diagnosed?
Because of its characteristic appearance, melasma is often diagnosed visually and with the use of a Wood’s Lamp which can distinguish excess melanin in the top skin layer from discoloration in the dermis. However, because melasma is caused by an underlying condition Dr. Zeena will review your medical history and determine the triggers that underlie your condition and make adjustments.
How is melasma treated?
First and foremost, treatment is geared at preventing aggravation of the condition by the sun which requires the diligent use of sunscreens that block the sun’s rays as well as the light and heat.
There are two kinds of sunscreens: one uses chemicals and the other uses physical blocking agents. The best choice is a physical blocking agent such as zinc and titanium dioxide. When spending time outdoors, wear a hat and long sleeves.
Topical medications to lighten the patches including retinols applied to speed up cell turnover can facilitate faster clearing. The addition of a skin lightening cream that contains hydroquinone, a bleaching agent that is supervised by Dr. Zeena to avoid areas of hypopigmentation. Kojic acid or azelaic acid are also topical skin lighteners that may be recommended.
Additional treatments include chemical peels and laser treatment such as Laser Genesis and Clear + Brilliant two of the latest and most effective dermatology skin resurfacing devices available. Combination treatments are the most effective. Dr Zeena will personalize a treatment plan to successfully address your specific needs, help the skin heal, and prevent future damage.
Melasma is a frustrating, chronic condition. At New Orleans Aesthetics, Dr. Zeena will work with you to obtain a good outcome including restoring your appearance and confidence. Contact her today to schedule a consultation and learn about all your options.
At a Glance
Dr. Zeena Al-Dujaili
- Double board certified in dermatology and Mohs Surgery
- Fellowship trained in cosmetic dermatology
- Authored several chapters in clinical textbooks and peer-reviewed publications
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