Melasma (Chloasma)

Melasma is a skin condition that can occur at any point in life. It is simply a type of skin discolouration found on areas of the face which has been exposed to the sun. Studies have revealed that people with darker or asian skin tones have a higher chance of developing the condition. It has been around for a number of years and can be avoided or treated in many ways.

There are three types of hypermelanosis. It could be either epidermal (brown), dermal (blue-grey), or a mixture of both (brown-grey). Melasma, also known as chloasma.

It is much easier to avoid than treat but treatments have been proven to be very successful in completely eradicating all the signs of darker skin on and around the face.

Melasma can be very worrying if never seen or heard of before but the fact remains that the percentage of complete eradication is very high if treated safely and correctly. Melasma is a harmless disorder. It is not related to cancer and it does not involve internal organs. Melasma is also known as Mask of Pregnancy. It also can develop on the forearms and neck. Melasma is much more common in women than in men. Women are affected in 90% of cases. When men are affected, the clinical and histologic picture is identical.

In some cases, a skin biopsy is necessary to confirm that the brown patches are melasma.

Causes

Melasma is thought to be the result of stimulation of melanocytes or pigment-producing cells by the female sex hormones estrogen and progesterone to produce more melanin pigments when the skin is exposed to sun. Women with a light brown skin type who are living in regions with intense sun exposure are particularly susceptible to developing this condition. Female hormonal activity appears to cause melanocytes or the pigment-producing cells to produce and deposit excess pigments, because it occurs with pregnancy and with the use of oral contraceptive pills. Other factors implicated in melasma are photosensitizing medications, mild ovarian or thyroid dysfunction, and certain cosmetics.

Ultraviolet radiation can cause peroxidation of lipids in cellular membranes, leading to generation of free radicals, which could stimulate melanocytes to produce excess melanin.

Genetic and hormonal influences in combination with ultraviolet radiation are the 2 most important causes of melasma, yet phototoxic and photoallergic medications and certain cosmetics have been reported to cause melasma in rare instances.

 Treatment

Topical depigmenting agents, such as hydroquinone (HQ) either in over-the-counter (2%) or prescription (4%) strength. Hydroquinone works by decreasing the production and increasing the breakdown of melanosomes (melanin pigment granules) in the skin's pigment cells (melanocytes).

Tretinoin, an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy.

Azelaic acid (20%), thought to decrease the activity of melanocytes.

Facial peel with alpha hydroxyacids or chemical peels with glycolic acid.

Laser treatment. A Wood's lamp test should be used to determine whether the melasma is epidermal or dermal. If the melasma is dermal, laser (or "IPL") will acually DARKEN and worsen the appearance of the spots. Dermal melasma is generally unresponsive to most treatments, and has only been found to lighten with products containing mandelic acid.

Regardless of the treatments used, all will fail if sunlight is not strictly avoided. Prudent measures to avoid sun exposure include hats and other forms of shade combined with the application of a broad-spectrum sunscreen at least daily. Sunscreens containing physical blockers, such as titanium dioxide and zinc oxide, are preferred over chemical blockers because of their broader protection. UV-B, UV-A, and visible light are all capable of stimulating melanogenesis. In addition, patients should be forewarned that resolution is gradual and may take many months.

Home remedies for melasma treatment

Use half water and half vinegar to rinse and cleanse your face and allow it to air dry.  Vinegar is an acid and can whiten and brighten your skin while also making it smoother.  Another natural method people have used is onion juice.  Chop up an onion and either blend it or squeeze out the juice using cheesecloth.  Mix the onion juice equally with apple cider vinegar and use a cotton ball to apply it to your face twice a day.  Lemon juice has also been known to have the same effects as vinegar because it, too, is an acid and can safely cause dark skin to fade in color.

Be sure to ask a doctor which treatment may be the best melasma treatment, because every person is different so each person will react differently and may have different results.