Melasma, also known as ‘chloasma’, is a chronic skin pigmentation disorder that can cause dark patches on the skin, especially on the face and upper lip. This skin condition is thought to affect more than 5 million Americans, especially women with darker skin types.
To better understand this skin condition, let’s first define melasma. The word ‘melasma’ comes from the Greek root melas, which means ‘black’. The same root is in the word ‘melanin’ (skin pigment). Your skin color is based on the amount of melanin present in your cells.
Melasma triggers, whether internal or external, stimulate an increased production of melanin that causes the dark patches on your skin.[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_column_text]
Melasma most commonly occurs on the face, although it can also appear on the arms and back. Melasma on the face typically appears on the forehead, the upper lip, the chin, or cheeks. Melasma may appear as ‘macules’, which resemble freckles, as well as larger dark patches that feature irregular borders.
Melasma symptoms include:
Melasma unfortunately cannot be cured, but it can be effectively managed with sun protective measures and professional dermatologic care.
Melasma occurs in about 1% of the general population (Ogbechie). However, this number can range between 9-50% in high-risk populations. The difference in prevalence may be attributed to an individual’s degree of sun exposure, geographic location, and genetics.
Women develop melasma at a rate disproportionately higher than men. Some studies have found a 9:1 ratio of female predominance (Hexsel) while others have found differences as high as 39:1 (Vazquez). This disparity is due to the naturally higher levels of estrogen in women’s bodies. Pregnancy and oral contraceptives – both of which increase the amount of estrogen in the body – can trigger melasma as well.
Genetics play a large role in the development of melasma. Women of Hispanic or Indian descent are especially prone. If you have family members who have melasma, you are more likely to develop the condition yourself. Studies have shown that more than half of people with melasma have a family history (Ogbechie).
Although rare, melasma can also affect men. The clinical presentation of melasma is very similar in men and women with dark brown patches and macules (freckle-like spots) that develop on the face, neck, shoulders, or upper arms. The major risk factors for developing melasma among men are sun exposure and performing work outdoors (Ogbechie).
As far as skin conditions go, melasma is not dangerous or painful, but it can be very troublesome all the same. So, what causes melasma? In truth, the exact cause is not known. However, there are several well-documented triggers.
Melasma is not a harmful condition, and some individuals choose not to seek treatment. However, scientific studies have consistently shown that melasma can negatively impact an individual’s quality of life both socially and professionally. But how can you treat this condition if it cannot be cured?
Melasma is very manageable, so seeking treatment can help reduce the appearance of dark patches as well as prevent these patches from coming back. There are many types of treatment, all of which can help fade and manage this skin condition.
No treatment plan is complete without sun protection because UV rays can make your melasma worse. All treatments should include at-home lifestyle modifications such as avoiding the sun during peak hours (10am – 2pm), wearing a broad-brimmed hat outdoors, and regularly applying a broad-spectrum sunscreen. Choose a sunscreen that contains either iron oxide or titanium dioxide (or even better, both). These ingredients are physical UV blockers that are particularly helpful in reducing the severity of the dark patches on your skin.
In addition, avoid using cosmetics or toiletries that irritate your skin since inflammation can cause your skin to become even darker.
Although melasma can fade on its own without any treatment, these options may take time. At-home, prescription-free remedies include avoiding the sun and wearing UV-rated clothing. Where this condition is caused by hormonal birth control pills or IUDs, stopping the use of these contraceptives can help dark patches fade. When pregnant women develop melasma, the dark patches generally fade after giving birth.
Unfortunately, melasma is often caused by uncontrollable factors such as skin type, genetics, and gender. However, prevention is still a critical component in dealing with existing melasma regardless of the type of treatment you use. While the condition is caused by a variety of factors, one which is both highly culpable and preventable is direct exposure to ultraviolet sunlight. It is responsible for aggravating existing hyperpigmentation and undoing the progress you have made towards achieving a clear complexion.
Any effective melasma treatment includes the daily use of a broad spectrum sunscreen. Sunscreen labeled as such has been required by the FDA since 2011 to protect against the two types of UV radiation (A and B) that are linked to the kind of skin damage linked to melasma.
Notably, UVA—the radiation most responsible for the kind of damage linked to melasma—is present during all daylight hours, and it is as present in direct sunlight as it is with overcast. This means that sunscreen is warranted at unintuitive moments, and it should likely be used more often than not.
Research suggests that physical UV blockers like iron oxide result in a lower melasma relapse rate over broad spectrum sunscreens that do not contain sunlight blockers.
Can you prevent melasma?
Kirsch Dermatology has helped many patients improve their complexion and manage their melasma with long-term results. One of the most important things to keep in mind when it comes to treating melasma successfully is that this condition can be notoriously slow to respond to treatment. However, with diligent use of our melasma cream and sun protective measures, we’re confident you will see noticeable improvements. Many of our patients report improvements within weeks of the first treatment and clear skin following after several months.
Our melasma treatment before and after photos demonstrate how we’ve helped our patients brighten up their complexion.
Melasma does not discriminate about who it affects, and many celebrities have this bothersome skin condition too.
Celebrities with melasma include: