Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Melasma?
This is a common medical condition that causes skin discoloration. You will notice it typically on your face, especially on your cheeks, forehead, and upper lip. It is also known by two other names which are mask of pregnancy and chloasma. It is referred to as hyperpigmentation by physicians. It most commonly affects women who are between the ages of twenty and fifty.
Sometimes men get it also, especially men of Latin or Central American origin. Most women that get melasma are dark skinned but it can occur in lighter-skinned people also. It is estimated that between forty and fifty million women world-wide with six million of them living in the United States who have this condition. It is a harmless medical condition and is not associated with any other medical condition.
The symptoms of melasma will many times develop gradually over time. Beyond the cosmetic discoloration there are no other symptoms. Some of the cosmetic discolorations that a person might see can include:
- Patches that are irregular in size and shape.
- Are blue-grey, tan, or dark brown in color.
The exact cause of melasma is not known but it is thought that one factor could be an increase in the cells that produce melanin. Researchers do not know exactly what causes this increase in the production of melanin cells but there are many different trigger factors. Some of these trigger factors can include:
- Pregnancy which causes many hormonal changes.
- Being on birth control pills.
- Using hormone replacement therapy.
- Exposing your skin to an extensive amount of sun.
- Taking or using certain medications that make your skin more sensitive to sunlight such as medications for ovarian or thyroid problems.
- Genetic predisposition
- Allergic reactions to certain cosmetics such as those that are scented or medications.
- Can develop in association with menopause.
- Having a deficiency of folic acid when pregnant.
If a man develops melasma there are certain triggers that can cause them to develop this medical condition, which can include:
- Their ancestry
- Excessive exposure to sunlight
- Family history
It is easy for a dermatologist to determine if a patient has melasma or not. The dermatologist would use a Wood Lamp, to make a confirmed diagnosis. Using this particular type of lamp the dermatologist is able to see the excess melanin in your skin and be able to distinguish it from your regular skin cells. If you are taking progesterone or estrogen supplements for hormone replacement therapy or are on birth control pills the dermatologist may not need the special lamp to make a diagnosis. If you are not pregnant, taking birth control pills, or on hormone replacement therapy, the dermatologist may send you to your physician to have blood tests done. This is to rule out lupus, which can cause you to have a butterfly mask over your cheeks, nose, and forehead.
Melasma will generally resolve on its own without any treatment as soon as there is a stabilization of your hormones. If a woman is pregnant her hyperpigmentation will fade with months after having the baby. If you are on hormone replacement therapy or taking birth control pills, the discoloration will fade once you stop the medications.
You should also make sure that you are protecting your skin from the excessive UV rays. Other treatments you can try if you do not want to wait for it to fade on its own may include:
using this method of treatment will cause you to have a mild burn, like a sun burn, on your skin. Over time, the layers of skin that have been chemically burned will peel off and in its place there will be fresh new skin.
The main trouble with using this method is that the stronger chemical peels could cause side effects like scarring, exacerbating the discoloration of your skin, and burning. You do need to use the stronger chemical peels because the milder one’s effectiveness is poor.
This is a kind of vitamin A that helps to increase the rate that you shed the dead cells of your skin and the new skin cells reappear. Using this treatment will help the melasma patches fade faster.
This treatment is a bleaching agent in a cream form. It will remove the pigment from your skin by helping to block the natural process in the production of melanin. You may need to use this type of treatment for six to eight months to get the results that you desire.
Before bedtime use retin-A cream on any affected area.
There are also natural treatments, also known as home remedies that you can use to help with melasma which can include:
- Make sure that you are using sunscreen every day with the right SPF, even if you are just going to be in the sun for a little while.
- When washing your face only use mild soaps or cleansers.
- Use fruit creams that contain lactic acid, glycolic acid, or fruit acid.
- Discontinue using make-up, lotions, facial cleansers, or creams that may irritate your skin.
- Take the anti-oxidant supplement Pycnogenol tablets three times a day with meals. They should be twenty-five milligrams.
- Use a lightening cream that is contains antioxidants, is potent, and natural for your skin.
- Use a moisturizing lotion to soothe and maintain your skin after you successfully cure melasma.
- Apply lemon juice using a cotton ball every night to the affected area. Leave it on for at least twenty minutes before you wash it off using warm water. You can do it twice a day if you want to.
- Use Aloe Vera gel from the Aloe Vera plant and apply it at night before you go to bed. Leave it on over night and wash it off in the morning with warm water. If you do not have a plant you can get the gel that is one hundred percent natural online.
This is a very effective way to treat melasma. It is referred to as the laser skin rejuvenation melasma treatment. For many people they use this as the last resort after trying other treatments that have not worked. When choosing this type of treatment there is three types of laser treatments in addition to topical medicines to choose from.
- Pulsed Light Laser
- Fraxel Dual Laser
- Q-switched Laser
Using one or more of these treatments has proven to be the most effective treatment for this medical condition. Using laser treatments may not cure melasma but with medications and frequent treatments it will help to clear up your case of melasma. When you have laser treatment it removes the layer of skin that is discolored.
Using this type of treatment can be expensive so it might be better to try other methods of treatment or wait for it to go away on its own first. The cost varies and depends on what type of laser treatment, the dermatologist who does the treatment, and how many treatments you will need. On average each visit can cost one hundred dollars.