Melasma…that annoying hyperpigmentation that doesn’t seem to go away

Melasma refers to an acquired (meaning that the person was not born with it) hyperpigmentation (a hypermelanosis because of increased melanin production in the affected areas) that symmetrically (affecting both sides of an area almost equally) affects areas most exposed to the sun on the face like the forehead, the cheeks, the upper lip and the chin. It can also affect other areas of the body exposed to the sun like the back and chest but affects the face more often.

It is called chloasma when it occurs in pregnancy. (Note that it is more common in females and up to half of cases start in pregnancy)

The exact cause is not known but there are three major factors.
1. A genetic predisposition
2. Hormonal changes
3. Sun exposure.

Let me tell you a little secret. A lot of conditions in medicine have causes that are multifactorial. Because of this…some conditions are better managed rather than completely treatable. Melasma is one of them.

The background predisposition of genetic and hormonal factors lead to increased melanin production in the presence of sun exposure. You will then understand that if the genetic/hormonal factors are not present in an individual, they will not develop melasma even with sun exposure. They may develop darkening but that is not synonymous with melasma.

Apart from pregnancy, use of oral contraceptives is also a risk factor in someone that has the genetic predisposition already. Melasma is also more common in dark skin types than lighter ones.

Melasma is better prevented than treated. Use a sunscreen with at least SPF 30 and avoid sun exposure as often as possible. If it has occurred already….be careful when you’re treating it. Make sure it is someone that knows what they’re doing.

A little secret…Anyone that is treating melasma and tells you…’once I’ve treated..it can never come back’ should be avoided. Melasma can always recur especially if adequate sun protection is not practiced (which is the most important part of management)

Don’t be in a hurry to get it out in 10 days. It didn’t start in 10 days either😊.
A combination of some creams +/- procedures like chemical peels, LASER in good hands will help control the pigmentation along with the liberal use of a sunscreen.


Any questions?

Photo from Verywell health via Google images