Melasma is a skin disorder characterized by dark areas on the face (forehead, cheeks and upper lip) and is caused by a buildup of pigment (melanin) in the skin. The dark areas are usually symmetrical and have definite boundaries (similar on both sides of the face). It's known as "chloasma" or the "mask of pregnancy" when it happens during pregnancy.
Although people with melasma may be concerned about its appearance, it is a harmless condition that causes no other health problems. Melasma is a prevalent skin condition that affects up to six million women in the United States.
Melasma is classified as "epidermal," "dermal," or "mixed."
Epidermal melasma means the pigment (melanin) is in the more superficial layers of the skin called the epidermis.
Melasma in the deeper layers of the skin is known as dermal melasma. This distinction is significant because epidermal melasma responds to therapy more quickly.
Although melasma can occur in men, it is most common in women, especially in women of Hispanic or Asian ancestry. If your relatives had melasma, you are also at greater risk of developing melasma.
Women are also at greater risk of developing melasma if they are pregnant, take birth control pills or take hormone replacement therapy.
People at risk of developing melasma will notice the patches becoming darker following exposure to sunlight.
Treatment results vary greatly among individuals. Your recommended treatment will depend primarily on your type of melasma: dermal or epidermal.
It may take time to respond to treatment, so be patient. Some people with epidermal melasma experience rapid improvement within four to eight weeks of starting treatment, while others may find that progress can take many months.
The medications prescribed for melasma cause the skin to stop making melanin.
Your doctor may discuss various dermatologic procedures that may reduce the appearance of the dark patches, including chemical peels, dermabrasion or lasers. Fractional lasers have also been found to be particularly effective for some types of melasma.
Avoiding exposure to sunlight is an essential step in treating melasma and preventing its return. Sunlight is a powerful trigger of pigment formation in people susceptible to melasma. It is strong enough to counteract the effects of medications and can even cause issues through car windows or on cloudy days.
If you must be in the sun, take the following measures to prevent the sun from contacting your face:
When selecting a sunscreen, consider the following: