WHAT IS MELASMA?
Melasma commonly appears as brown-grey patches on the face. Although an exact is cause is not known, many factors are related.
#1) Ultraviolet (UV) light from the sun stimulates the melanocytes (pigment cells in your skin).
This is why:
Melasma is often worse in summer.
Even a small amount of sun exposure can make melasma return after fading.
Many people with melasma get it again and again.
#2) Female Hormones
Pregnant women often get melasma (called chloasma, or the mask of pregnancy).
Birth control pills and hormone replacement medicine also can trigger melasma.
#3) Skincare Products:
Simply put, if a product irritates your skin, it can trigger/worsen melasma.
#4) Genetics:
Over 40% of patients report having relatives affected with this condition
#5) Blue light from LED screens?
Recently, some studies have suggested a connection between blue light from LED screens and melasma. This has not been yet been substantiated via strong scientific studies.
TREATMENT
Treatment Principles:
Sun protection: Arguably more important than treatment because it prevents worsening discolouration
Stop further pigmentation: Melasma is not a static condition, and can darken / enlarge over time, depending on various aggravating factors
Remove existing pigmentation: The most effective treatment often involves both prescription topicals & professional procedures (e.g. chemical peels, laser treatments, etc)
Initial Treatment:
Prescription hydroquinone (HQ) combination creams
Combination creams contain additional prescription-level ingredients including kojic acid, retinoids, and others
HQ inhibits tyrosinase, a protein that helps to produce skin pigment
Over-the-counter HQ 4% versions are often insufficient to produce a notable effect
⚠️Topical HQs should be used under medical supervision due to pigmentation risks with long-term use ⚠️
Maintenance Treatment:
Because HQ cannot be used safely long-term, non-HQ topical options are used for maintenance
Azelaic acid
Kojic acid
Niacinamide
Vitamin C
Arbutin
Etc
These formulations can be used in an alternating fashion with HQ treatment periods
Ongoing Treatment:
Daily SPF30 photoprotection, ideally with a tinted, mineral formulation to block visible light
Removing risk factors: oral contraceptives, hormonal treatments, etc
Professional Procedural Treatments:
Chemical peels
Lasers treatments
⚠️Always speak to a Board-Certified Dermatologist to guide your decision ⚠️
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