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 has traditionally been a very difficult condition to treat but recently there has been an exciting new development in the treatment of this condition. We are now using injections of a small quantity of tranexamic acid which is delivering great results without any side effects.
 
Other options still exist including depigmenting creams that if used under strict medical guidance and in conjunction with other treatments such as chemical peels, can improve the condition.
 
Chemical peels can be effectively and safely performed on patients with melasma and in particular resorcinol peels, pyruvic acid peels and retinol peels (see section on chemical peels for details).
 
Any patients with melasma need to avoid sunlight completely, use total sunblock and wear sunhats and glasses if they decide to treat the condition.