What is Melasma?
What causes melasma & how do I know if I have melasma?
Melasma is the result of increased activity of melanocytes, which are the cells responsible for the production of melanin. Melanin is the pigment you see in the skin. Subsequently, excess melanin accumulates in the skin, causing local hyperpigmentation. While the exact trigger of increased melanocyte activity is unknown, it has been postulated that an increase of melanocyte-stimulating hormone (MSH) levels, accompanied by higher levels of estrogens and progesterone play an important role.
Melasma often is a singular, well – demarcated, brown macule but sometimes consists of multiple, symmetrical spots on the skin. A macule is a lesion at the level of the skin – it cannot be felt when you touch it, like a freckle.
What can I do to prevent melasma?
- Wear a year – round high SPF (50+) sun protection, and reapply every 80 minutes. For better results, use a broad – brimmed hat, and seek shade when possible.
- Use a gentle, dermatologically tested cleanser as well as a non – comedogenic moisturizer.
- Consult it with your doctor if hormone therapy should be appropriately adjusted or stopped.
What are treatment options for melasma?
n some cases, melasma disappears with resolution of the precipitating factor, like pregnancy, or adequate thyroid treatment. In more recalcitrant cases, suitable pharmacological treatment is necessary.
The main goal in therapy of melasma is to inhibit the melanin production pathway. Topical tyrosinase inhibitors like hydroquinone are often implemented as the first choice treatment. Tyrosinase is one of the enzymes involved in melanogenesis (melanin production). Other melanogenesis inhibitors include: azelaic acid, kojic acid and ascorbic acid (vitamin C). Agents which cause superficial peeling have also been proven effective, as they lighten hyperpigmentation, and allow for better penetration of melanogenesis inhibitors into the skin. Suggested therapies include topical retinoids such as tretinoin, topical AHA/BHA acids, salicylic acid, and tranexamic acid. Combination therapy has proven most effective. PS Dermatology & Surgery will devise a therapeutic plan most suitable to your needs.