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Melasma Prevention and Treatment (General Skin Care)
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Melasma Prevention and Treatment

Dr. Mariusz J.A. Sapijaszko, MD FRCPC (Dermatology)

Frequently asked question:
Every year my face gets darker and darker especially during the summer months. I don’t mind the color but it is very uneven and blotchy. What is happening and what can I do about it?

Answer:
The condition that you are talking about likely represents MELASMA. Melasma represents increased pigmentation of the facial regions that particularly affects women. It is one of the most common reasons that women seek the advice of dermatologists. Although it is one of the most frustrating conditions to treat as the “veil” of increased pigmentation descends over the face, there is a lot of good news in the fight against this rampant affliction, raising hopes that truly effective remedies are just around the corner.

Melasma, localized to the face, is seen primarily in women. Irregular light to dark brown areas of pigmentation occur on the forehead, temples, upper lip, chin and cheeks. It is more common in patients with darker skin although patients with all skin types can be affected. Melasma mostly presents in the 20s, 30s, and 40s although it is occasionally seen in other age groups.

There are many causes of melasma. Ultraviolet radiation (sunshine and tanning beds) is the most important factor in causing this dreaded skin condition. This is supported by the findings of melasma starting and worsening in the summer. Other factors that are important include hormonal influences (pregnancy and the use of birth control pills,) genetic predisposition (patients with the family history of melasma have higher chances of developing melasma themselves) as well as the use of irritating or fragrant skin care products.

The most important factor preventing the development as well as worsening of melasma is appropriate facial sun protection with broad-spectrum sunscreen (UVA and UVB) as well as avoidance of tanning beds. This point can not be overemphasized.

Once melasma develops, we still need to continue sun protection as well as the introduction of pigment modifying methods. Hydroquinone, vitamin A derivatives, azelaic acid, topical vitamin C, kojic acid as well as glycolic and salicylic acid are the topical products with the most success. These can be used in over-the-counter (drug stores and cosmetic counters) as well as prescription strength varieties (dermatology offices as well as pharmacies with doctor prescription). In addition, chemical peels (glycolic acid and salicylic acid) as well as light based technologies (IPL – Intense Pulsed Light and laser) can be used by the experts. It is important to seek help from a qualified expert when seeking treatment for melasma. The danger of inappropriate treatment is that melasma can get significantly worse – really complicating future therapies. It is also important to note that, at least some of the treatments for melasma have to be continued for quite some time in an effort to keep melanocytes from becoming overactive.

Melasma is a common yet frustrating condition to treat. The good news is that with early therapy, appropriate facial sun protection, topical preparations, chemical peels as well as light-based technologies most patients can expect good results. It is critical to see an experienced skin expert such as a dermatologist for accurate diagnosis as well as optimal therapy. Don’t allow melasma to cast a shadow on your inner beauty.

Related:

general health,   hyperpigmentation,   laser treatments,   melasma,   sun damage,   sunscreen,