Embrace clear, radiant skin with our comprehensive guide to melasma treatment. Discover proven therapies, expert tips, and lifestyle changes to manage melasma and restore your confidence.
Usually, melasma fades on its own over several months. If it appears during pregnancy, it usually goes away after the baby is born. However, it may come back in future pregnancies or with use of birth control pills.
Your doctor can diagnose melasma with a visual exam and tests like a skin biopsy or a Wood’s lamp. Your doctor may prescribe hydroquinone, corticosteroids or tretinoin creams that lighten the discolored patches.
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Sun Avoidance during Melasma
Sun avoidance is an essential part of treatment for melasma. Sunlight triggers melanin production, which darkens skin and creates patches of discoloration. Sun avoidance and sunscreen use prevents the melasma from getting worse.
Using a high, broad-spectrum sunscreen is one of the most effective treatments for melasma. Using a sunscreen with a UVA/UVB rating of 30 or higher protects against both the damaging effects of UVA and UVB rays. This is particularly important in patients with melasma, as melasma often triggered by sun exposure.
It is also a good idea to use a facial sunscreen with a light tint. This can help conceal the appearance of dark spots and make them less noticeable, improving the psychosocial impact of melasma. In addition, using a light tint can reduce the amount of sunscreen needed when protecting against the sun.
There are some melasma triggers that are not controllable. Pregnancy, birth control pills and certain medicines like tetracycline, antibiotics, blood pressure medicine and anti-seizure medications can all trigger melasma by increasing the levels of estrogen and progesterone in your body. Stress can also trigger melasma by raising cortisol, which increases pigmentation.
For some people, melasma will fade on its own once the hormone change that caused it stops. If melasma developed during pregnancy, it will usually fade once the baby is born or once you stop taking birth control pills. For other people, however, melasma may last for years and need to treat.
To treat melasma, dermatologists can prescribe topical bleaching creams that help to even out skin tone and remove darker spots. Dermatologists can also recommend a topical sunscreen with a high, broad-spectrum UVA/UVB protection. mesoprotech(r) melan 130 pigment control is a good choice, as it provides very high sun protection with both UVA and UVB rays (131 and 67, respectively). This will help to prevent further skin hyperpigmentation, and will keep the melasma from coming back once the triggering factor has stopped. The most important thing to remember is that, despite the effectiveness of these treatments, melasma will not completely disappear.
Hormone Therapy
Many people with melasma have a combination of skin conditions, including liver spots (hyperpigmentation), and they need to take special care to protect their skin. If the melasma caused by sun exposure, using sunscreen with high SPF is helpful. However, the sunscreen must also be broad spectrum to protect against UV-A and UV-B radiation, which are triggering factors for the melasma. In addition, hormonal changes can trigger melasma. Female hormones, especially estrogen and progesterone, can play a role in the development of melasma, particularly during pregnancy. In fact, melasma sometimes called the mask of pregnancy because it commonly occurs during the third trimester. Hormonal medications, such as birth control pills and hormone replacement therapy, can also cause melasma.
Dermatologists usually can diagnose melasma during a visual examination, but a biopsy may require to rule out other diseases. A small sample of the affected area removed and examined under a Wood lamp, or in some cases with a dermatoscope. Often, melasma can treated with topical medications and sunscreens, but in more severe cases, other treatments may recommend.
Some of the most common treatments include chemical peels, azelaic acid and tranexamic acid. These treatments can lighten the pigmentation in melasma and other hyperpigmentation, but they may need to repeated regularly. In some cases, these treatments combined with laser treatment to achieve the best results.
Another treatment option is a topical medication that works by inhibiting the conversion of plasminogen to plasmin, which is a key enzyme in the formation of prostaglandin. This can help inhibit melasma by keeping the melanocytes from producing as much pigment as they would without this inhibitor.
Although it not fully understood why melasma develops, it is known that genetics and hormonal changes are major triggers. Melasma can often disappear on its own once the hormones change, such as after a person stops taking oral contraceptives or when pregnancy ends. In other cases, a dermatologist may prescribe medications that suppress the production of melanocytes. These medications can use alone or in conjunction with a skin lightener.
Medications
Melasma can’t prevented, but it’s possible to reduce its severity by taking certain steps. Limiting direct sunlight exposure during peak hours, diligently using a broad-spectrum sunscreen (SPF 30 or higher) with zinc oxide, titanium dioxide and iron oxide, not smoking and not exposed to irritating chemicals can help. Taking oral supplements with vitamin C and azelaic acid has also shown to improve skin tone.
For mild melasma, your doctor may recommend topical medications to lighten discolored patches of skin. These include hydroquinone, a corticosteroid and tretinoin, which are available by prescription. You can get these treatments as creams, lotions and gels that applied directly to the affected areas of your skin. You can also find combination treatments, such as triple creams, that contain all three ingredients. Other topical medicines include azelaic acid, which is safe for pregnant women, and cysteamine.
Your doctor can tell if you have melasma by looking at your skin, or they might use a special lamp that shines ultraviolet light on your face for a closer look. In rare cases, they might want to take a small piece of skin (biopsy) to make sure the brown spots are actually melasma and not something else.
Some melasma fades on its own, especially the epidermal type that appears on the surface of your skin. Other melasma can treated with creams that lighten the skin, such as 2% hydroquinone. You can apply these creams to the affected area of your skin twice a day and then cover with a sunscreen that is SPF 30 or more.
A few other options are laser treatments that target and break up the pigment that causes melasma. Oral and injectable glutathione products sometimes used, but these can be dangerous because they can affect your thyroid and kidney function.
In severe cases, your healthcare provider might advise tranexamic acid, which is an anti-dystrophy drug that can use as either a tablet or an injection. Long-term management is highly individualized and requires close monitoring. Your healthcare professional might decide to give you a short break from the medication every few months, so your body doesn’t become accustomed to it.
Laser Treatments for Melasma
Laser treatments can used alone or in combination with topical agents and medications as a form of light-based skin rejuvenation. They help by breaking up pigmented cells and allowing the skin to shed these dead cells, leaving it clear and more youthful looking. It is important to use a physician who not only has the right tools, but also understands that each type of skin needs to treated differently. The wrong laser can make the condition worse.
Intense Pulsed Light (IPL) consists of a handheld device that delivers pulses of light energy to the skin. This energy absorbed by the melanin that’s causing the problem and breaks it down. The body’s natural processes will then eliminate these broken-down cells over time, clearing the skin and reducing the appearance of melasma.
Photofacials are a great option for patients who have treatment-resistant melasma. These treatments involve a series of small treatments at regular intervals. These treatments will target the underlying cause of the pigmentation and help stimulate collagen production, resulting in healthier skin.
Fractional laser therapy is another treatment option for melasma. There are several different types of fractional lasers, and the best choice will depend on the severity of your melasma and other skincare issues. These include non-ablative fractionated, low fluence Q-switched, and picosecond laser technology. These lasers offer significant improvement in melasma by targeting the deeper layers of the skin and damaging the melanocytes responsible for hyperpigmentation.
A physician who specializes in lasers for pigmented skin, such as a board-certified dermatologist, will be the best choice for treating your melasma. These physicians are more likely to take the time to evaluate what’s going on medically that’s triggering the condition, and they have invested in all of the technologies it takes to treat this difficult condition well across all skin types and variations in its expression.
In addition to laser treatments, a skilled dermatologist can recommend other effective solutions for your melasma. Chemical peels and microdermabrasion can lessen the appearance of dark patches but won’t eradicate them. Microneedling can help by creating a controlled wound to encourage the growth of healthy, new skin and may combine with other treatments like IPL or microdermabrasion for more dramatic results.
