Melasma
What is Melasma?
Melasma (also called chloasma) is a common skin condition characterised by dark patches or freckle-like spots that usually appear on the face. Melasma can be light brown, dark brown, and/or blue-grey and usually affects the cheeks, bridge of nose, forehead, chin and above the upper lip.
The onset of melasma typically occurs between 20 and 40 years of age. About 90% of people who get melasma are women. Melasma is very common in pregnancy and is often referred to as ‘the mask of pregnancy’, with around 15% to 50% of pregnant women developing it. It is more likely to affect people with darker skin types or people who tan well. Melasma spots are harmless and often get worse (darker) in summer and better (lighter) in winter.
Types of Melasma
Melasma is classified into three types which are related to how deep the pigmentation is. These are:
Epidermal — dark brown patches with a well-defined border that respond well to treatment
Derma l— light brown or bluish colour with a blurry border that doesn’t respond well to treatment
Mixed Melasma — the most common type with bluish and brown patches and has some response to treatment
What are the symptoms of Melasma?
Melasma causes patches of discoloured skin, most often on the face. However, other parts of the body that are often exposed to the sun may also be affected, such as the neck and forearms. Typical symptoms of melasma may include:
patches of skin that are darker than your usual skin colour
symmetrical patches (matching marks on both sides of the face)
patches that appear on your cheeks, forehead, bridge of nose and chin
What causes Melasma?
Melasma occurs when the cells responsible for producing the pigment in your skin (melanocytes) produce too much melanin (the pigment that gives your skin its colour). It’s not entirely clear what causes this overproduction but several factors can increase your risk. These include:
family history — 60% of people with melasma have other family members with the condition
around 25% of women with melasma are either:
pregnant
use oestrogen/progesterone-containing oral contraceptives
have an intrauterine device or implant
use hormone replacement therapy
thyroid issues
sun exposure
certain medications such as cancer drugs, and cosmetic products may cause a phototoxic reaction in the skin resulting in melasma
How do you treat Melasma?
Sometimes melasma disappears by itself. This often happens in cases linked to pregnancy or oral contraceptives. However, some cases can be difficult to treat and people may have the condition for years or even a lifetime. There are different types of treatments used to reduce the appearance of melasma, some of which are administered under the guidance of a dermatologist (skin specialist) and include:
using sun protection such as a broad-spectrum, water-resistant sunscreen (SPF30+) along with a wide-brimmed hat
discontinuing the use of oral contraceptives or intrauterine devices
using makeup to conceal the melasma
topical creams such as:
hydroquinone cream or lotion (2-8%)
vitamin A creams
ascorbic acid (vitamin C)
azelaic acid (20%)
combination topical creams
chemical peels, although these have mixed success
laser therapy
It’s important to understand that melasma may be slow to respond to treatment, particularly if it has been present for a long time. Even if it responds to treatment, pigmentation may still reappear.
What are the complications of Melasma?
Melasma is not a serious condition, or linked to any underlying condition. It is also not cancerous, nor does it increase your risk for skin cancer. However, some people may find the condition distressing and embarrassing.
There is also the possibility that treatment for melasma may involve adverse side effects such as skin irritation and eczema, which is why it’s important to work with a dermatologist.
When should you see your doctor for Melasma?
If you have noticeable pigmentation on your skin or have noticed other visible changes to your skin’s surface, it’s wise to see your doctor as melasma can look like other skin conditions. Your doctor may provide you with a referral to see a dermatologist for further investigation and treatment.
It’s also recommended that you have regular skin checks with your GP or a skin cancer clinic to make sure any changes in your skin is not due to skin cancer.
Can you prevent Melasma?
Not all cases of melasma can be prevented. However, using good sun protection (including a water-resistant broad spectrum sunscreen of SPF30+ or higher, covering up with long sleeved shirts, and wearing sunglasses and hats)may reduce your risk.
Your local MediADVICE pharmacist is available to help you manage your health. Speak to your MediADVICE pharmacist about your skin symptoms so we can recommend products and medications that may be suitable for you, or refer you to a doctor if necessary.
Visit your nearest MediADVICE today