Understanding Melasma: Causes and Effective Treatment Options

December 23, 2023

Melasma, a common skin condition, can be a source of frustration for many individuals seeking a clearer complexion. In this blog post, we will explore the causes of melasma and delve into effective treatment options available in the world of advanced skincare.

What is Melasma?

Dr Farah Kassam, Cosmetic Physician at Pacific Plastic Surgery in Vancouver, says, ““Melasma is a pigmentation disorder which typically presents as dark discoloured patches on the face.” These patches often develop on the cheeks, forehead, nose, or upper lip, and their formation is associated with an overproduction of melanin, the pigment responsible for skin color. Melasma is more prevalent in women, and it is most commonly seen in individuals with darker skin types.  

Key characteristics of melasma include:

1. Hyperpigmentation: Melasma is primarily a pigmentation disorder, and the patches arise due to an overproduction of melanin, the pigment responsible for skin color. The excess melanin is often triggered by sun exposure and hormonal changes.
2. Symmetrical Patterns: The patches of melasma often appear in symmetrical patterns on both sides of the face.
3. Triggers: Several factors can contribute to the development of melasma, including exposure to ultraviolet (UV) light from the sun, hormonal changes (such as those associated with pregnancy or oral contraceptive use), and genetic predisposition.
4. Common in Women: While men can also develop melasma, it is more commonly seen in women, especially during pregnancy (often referred to as “pregnancy mask” or “chloasma”) or when using birth control pills. Hormonal fluctuations are thought to play a role in triggering melasma in susceptible individuals.
5. Chronic Condition: Melasma can be a chronic condition that requires ongoing management. Even with treatment, the pigmentation may recur if preventive measures, such as sun protection, are not followed.

Treatment Options

Dr Kassam states that “melasma can be a challenging condition to treat, and therefore a multifaceted approach with combination therapies are often required”. Typical treatments can include:

1. Topical Treatments

Hydroquinone: A skin-lightening agent that reduces the appearance of dark patches.

Retinoids: Encourage cell turnover and can help lighten melasma.

Topical Steroids: May be prescribed in combination with other agents for more effective results.

2. Chemical Peels

Certain chemical peels, such as those containing glycolic or trichloroacetic acid, can exfoliate the skin and reduce the appearance of melasma.

3. Laser Therapy

Intense Pulsed Light (IPL): Targets pigmented areas, breaking down excess melanin.

Fractional Laser Stimulates collagen production and helps improve skin tone.

4. Microneedling

This minimally invasive procedure involves the use of tiny needles to stimulate collagen production, promoting a more even skin tone.

5. Skincare Products

ZO Broad-Spectrum Sunscreen: Essential for melasma management, as UV exposure can exacerbate pigmentation.

ZO 10% Vitamin C serum: Known for its brightening properties and ability to even out skin tone.

Preventive Measures

Dr Kassam explains that “prevention is a key part of the management plan, which primarily consists of sun protective behaviours”.

• Consistent sun protection is crucial, including the use of sunscreen with high SPF and sun-protective clothing.
• Hormonal factors should be addressed, especially during pregnancy or while using hormonal contraceptives.

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