Melasma

What is melasma?

Melasma, also known as cloasma, is an acquired pigmentation triggered by sun-exposure. It presents as symmetric hyperpigmented patches mainly localized on the forehead, cheeks and upper lip, but it may occur in other sun-exposed areas.

What causes melasma?

The cause of melasma is still unknown. However, it has a direct relationship with female hormonal activity such as pregnancy and use of contraceptive pill.

Melasma is much more common in women but can also affect men. All skin types can be affected but it is more common in darker skin types (Asians and Hispanics).

The most important factor for the development of melasma is sun-exposure. During the initial phases of the disorder the pigmentation appears immediately after sun-exposure and tends to disappear completely with avoidance of the sun.

After subsequent periods of sun-exposure, the pigmentation becomes darker and does not disappear spontaneously any longer just with avoidance of the sun.

How can melasma be treated?

Melasma can be very difficult to treat. Strict avoidance of sunlight is mandatory. Patients need to use total sun block creams on a daily basis and wear physical sun protection (hats, sunglasses etc) if they decide to treat the condition.

Depigmenting creams, used under strict medical guidance, improve the condition, but need to be associated to other treatments, in particular chemical peels.

Laser treatment in our experience may not be effective and also worsen the condition. In our clinic we do not treat this condition with any laser or IPL device.

Chemical peels can be effectively and safely performed on patients with melasma, and in particular resorcinol peels and pyruvic acid peels (see section on chemical peels for details).