MELASMA

What is Melasma?

Melasma is a prevalent and recurrent skin condition characterized by the development of gray or brown patches on the skin, with the face being the most commonly affected area. While melasma predominantly affects women, men (around 26 to 32% in India) can also experience it. It frequently arises after pregnancy, earning it the moniker "mask of pregnancy" or Chloasma. Melasma typically manifests between the ages of 28 to 37 years. Individuals with darker skin tones and those with prolonged and frequent sun exposure are more prone to developing melasma.

What are the causes of melasma?

Melasma occurs due to overactivity of melanin-producing cells called melanocytes, resulting in excess melanin production. It is more prevalent in individuals with darker skin tones due to their higher melanocyte activity. Various factors can trigger this overproduction of melanin and lead to melasma:

• Hormonal influences such as pregnancy, hormonal therapies, and oral contraceptives
• Exposure to sunlight, including ultraviolet and possibly visible light
• Family history of melasma
• Skin phototype, with darker skin being more susceptible
• Thyroid disorders
• Stress
• Excessive use of cosmetics
• Certain medications like photosensitizing drugs and anticonvulsants
• Deficiencies in iron or zinc
• Low testosterone levels in men

What are the symptoms of Melasma?

Melasma typically appears as dark, brown, or greyish-brown patches on the skin, often symmetrical on both sides of the face. The common sites where melasma develops include:

• Cheeks
• Forehead
• Bridge of the nose
• Upper lip and chin
• Jawline

On the face, melasma may manifest in three patterns: central, malar (outer part of the cheeks, which is the most common type), and mandibular (along the lower jawline).

How is Melasma Diagnosed?

In most cases, a dermatologist will perform a clinical examination and ask specific questions to diagnose melasma. They may also use tools like a Wood's lamp examination or dermoscopy to assess the depth of pigmentation. In rare cases, a skin biopsy may be necessary to differentiate melasma from other causes of pigmentation.

Is melasma treatable?

Melasma may naturally fade over time or persist for years if not treated. Even after fading, it often returns. Treatment focuses on reducing pigmentation, but there's no guarantee that it won't recur.

What are the treatment options available for Melasma?

For optimal results in treating melasma, a combination of multiple modalities is often necessary. Medical treatment serves as the initial step in this comprehensive approach. If needed, chemical peels and laser treatments can be combined to expedite results, especially for patients who haven't responded well to medical therapy alone. Significant improvement is typically seen within 4-5 months, after which maintenance treatment may be required. Here are the available treatment options for melasma:

• Medical treatment forms the cornerstone of any pigmentation treatment plan. Upon examining your skin, your doctor will devise a personalized treatment strategy. Depending on your skin's condition, medical treatment may encompass one or more of the following interventions:
• Broad-spectrum sunscreen: Your doctor will prescribe this sunscreen to provide comprehensive protection against UVA and UVB rays. Adhering strictly to your doctor's instructions on its usage is crucial for experiencing its beneficial effects.
• Skin lightening creams: Melasma creams typically contain ingredients such as hydroquinone, arbutin, licorice extract, N-acetylglucosamine, Vitamin B-3 (niacinamide), as well as peeling agents like glycolic acid and retinoids.
• Oral medications for melasma
• Chemical peels for melasma:Chemical peels for melasma involve a procedure that boosts skin cell turnover, eliminating the outer layers of dull, blemished, and wrinkled skin to unveil fresher and younger-looking skin beneath. This treatment can be applied to various areas such as the face, neck, chest, back, hands, and even arms and legs. The peels are administered as gels or solutions, prompting the shedding of dead skin and the emergence of new skin with enhanced tone and texture.
• IPL treatment/Photofacial: IPL treatment, also known as Photofacial or Fotofacial, involves using intense pulses of light to penetrate deep into the skin for rejuvenation. This technology targets various pigmentation issues and skin conditions:
• Reducing the appearance of sunspots and freckles.
• Lessening hyperpigmentation.
• Treating skin flushing and redness.
• Addressing vascular lesions such as broken capillaries, blood vessels, telangiectasia, and rosacea, along with associated dark pigmentation.
• Improving overall facial tone and skin texture.
• Glutathione therapy:Glutathione therapy involves using a potent antioxidant called Glutathione, which defends the body by targeting and neutralizing reactive oxygen molecules and free radicals. Administered intravenously along with Vitamin C, this combination combats free radical damage, supports cellular health, and prevents collagen deterioration. By reversing oxidative cell damage, it promotes skin health and contributes to a more even-toned complexion.Glutathione accelerates cell renewal, replacing damaged cells with new ones, resulting in brighter, more radiant skin. It also hinders melanin production, the pigment responsible for skin coloration, leading to a visibly brighter appearance.
• Co2 resurfacing:CO2 resurfacing, also known as superficial skin resurfacing or Laser Skin Lift Treatment, is beneficial for treating stubborn melasma. It can also be utilized before peels to enhance their effectiveness.
• Microdermabrasion:Microdermabrasion, also known as MDA or skin polishing, is a non-invasive procedure that delicately exfoliates the skin, effectively eliminating the outermost layer of dead skin cells. This reveals a rejuvenated and more radiant complexion without the need for downtime, making it a safe and convenient lunchtime treatment.
• Carbon facial:Carbon facial, originating from Asia and also referred to as charcoal facial or charcoal peel, is an innovative non-invasive laser procedure designed to enhance skin brightness, softness, firmness, and smoothness. This treatment targets skin imperfections and enlarged pores, leading to a reduction in pore size and a refined, porcelain-like complexion. Popularly known as the China Doll Facial, it is particularly advantageous for individuals with oily skin, blackheads, enlarged pores, dull skin, and facial or body acne. Additionally, it serves as an effective exfoliation method, revitalizing the skin and delivering immediate refreshed results.
• Dermal therapies: Dermal therapies encompass a range of treatments such as clean-ups, Medi-facials, HydraFacial, and Oxygeneo facial. These treatments are highly effective, hygienic, and medically endorsed for facial rejuvenation. They work by deeply cleansing, exfoliating, rejuvenating, and hydrating the skin. Infused with essential nutrients and oils, these therapies are tailored to suit individual skin types, promoting healthy, radiant, and revitalized skin. They are particularly beneficial for addressing concerns like acne-prone, dull, dehydrated, and sun-tanned skin. It is recommended to undergo one therapy session every 3-4 weeks for optimal results.