What is Melasma?
Even if you do not have melasma, you likely know someone who does. Melasma is a common skin condition, especially among women. Much like Vitiligo and Dermatosis Papulosa Nigra, melasma is not dangerous. However, many patients seek treatment for the condition for cosmetic reasons, since melasma causes dark patches of hyperpigmentation on the skin.
Melasma typically occurs in dense patches of pigmented skin on the forehead, cheeks, upper lip, chin, and jawline. The patches are brown, tan or gray in color. Melasma can also present in other areas of the body, such as the arms and chest, especially if they have regular exposure to the sun. Your dermatologist may classify your melasma according to where it appears on the facial skin: centrofacial (forehead, cheeks, above the lip and chin), malar (cheeks and chin) and ramus (jawline).
In addition to its location, melasma is categorized according to the appearance of the patches. Your dermatologist may classify your melasma as one of the following types:
- Epidermal Melasma: Generally presents as well-defined, dark brown patches and is considered the easiest type to treat.
- Dermal Melasma: Presents with less-defined, light brown or gray patches.
- Mixed Melasma: Presents as a combination of epidermal and dermal melasma and is the most common type of skin condition.
What Causes Melasma?
Like some other common skin conditions, the exact causes of melasma are not entirely known to doctors. Research suggests that melasma may be genetic and more common in people with skin of color. Those who have darker skin tones have more active melanocytes, which makes them more prone to hyperpigmentation.
Many people who experience melasma first notice the hyperpigmentation during hormonal changes. Women who are taking oral contraceptives, who are pregnant or who are receiving hormone treatments may be at a higher risk of developing melasma. Melasma is sometimes called “the mask of pregnancy” because of its frequency among pregnant women. Direct exposure to UV rays is considered another common cause of melasma.
Who Can Develop Melasma?
Melasma is typically found in women. Approximately 10 percent of melasma patients are male. The skin condition usually appears in women between the ages of 20 and 40, but it can also arise in women up into their 50s. Women who become pregnant or take hormonal contraceptives are also at an increased risk of developing melasma.
Melasma is more common among people with darker skin tones. Their melanin-producing cells are much more active. When these cells are exposed to UV rays, they can become super-active, producing more dark pigment and resulting in the signature dark patches.
At Buckhead Dermatology, conveniently located in Buckhead, Atlanta, Dr. Straughn provides individualized melasma treatment for patients throughout Atlanta and surrounding communities, including Sandy Springs and Brookhaven. With extensive experience treating skin of color, Dr. Straughn understands the challenges of managing hyperpigmentation across different skin tones and develops treatment recommendations based on each patient's individual needs.
Frequently Asked Questions About Melasma Treatments
1. Can melasma be permanently cured?
Melasma is a chronic skin condition that can be successfully managed, but there is no permanent cure. Treatments can significantly fade dark patches and improve overall skin tone. However, melasma can return, particularly with sun exposure or hormonal changes. Consistent sun protection and a dermatologist-recommended skincare routine are essential for maintaining results.
2. How long does it take to see results from melasma treatment?
Most patients begin noticing improvements within 8 to 12 weeks, although results vary depending on the severity and type of melasma. Deeper pigmentation may take several months to improve. Dr. Straughn evaluates each patient's skin and recommends a treatment plan based on their individual needs, skin tone and pigmentation concerns.
3. Is melasma treatment safe for darker skin tones?
Yes, melasma can be treated safely in patients with darker skin tones, but choosing the appropriate treatment is especially important. Skin of color can be more susceptible to post-inflammatory hyperpigmentation, meaning certain aggressive treatments may worsen discoloration. Dr. Straughn considers each patient's skin type and pigmentation before recommending topical medications, chemical peels or other treatment options.\
4. Can chemical peels help treat melasma?
Yes, chemical peels can help reduce the appearance of melasma by exfoliating the upper layers of skin and improving uneven pigmentation. Superficial chemical peels are often used alongside prescription topical treatments and daily sun protection to improve results. However, not all chemical peels are appropriate for every skin type. Aggressive peels can worsen pigmentation, particularly in patients with darker skin tones. At Buckhead Dermatology, Dr. Straughn evaluates each patient's skin to determine whether chemical peels are an appropriate part of their melasma treatment plan.
5. What is the best sunscreen for preventing melasma from returning?
Daily use of a broad-spectrum sunscreen with SPF 30 or higher is essential for managing melasma. Tinted mineral sunscreens containing iron oxides are particularly beneficial because they help protect against visible light, which can worsen pigmentation. Patients should also limit direct sun exposure, wear protective hats and reapply sunscreen throughout the day.
Melasma Treatments Buckehead Atlanta
If you are experiencing dark, symmetrical patches on your skin, schedule an appointment with a board-certified dermatologist like those at Buckhead Dermatology. Our dermatologist will evaluate your hyperpigmentation and visually diagnose it as melasma. In some cases, the doctor may need to perform further testing to rule out other conditions.
A diagnosis of melasma is not life-threatening, nor is it dangerous. Many patients opt for treatment because they do not feel confident with the dark patches covering their skin. The treatment options for melasma aim to reduce the appearance of brown patches; however, patients must take precautions to protect their skin. Even after treatment, melasma triggers can induce the reappearance of the dark spots. Your dermatologist will discuss how you can protect your skin to prevent the patches from returning or getting darker.
There are a variety of treatments available for melasma. Visit your dermatologist to learn more about your options and discuss the best course of treatment for your skin. Some of the most common treatments include:
- SPF: If you have melasma, the most critical prevention and treatment measure is the consistent use of a broad-spectrum sunscreen. The sun is one of the primary triggers of melasma. Even if you are using other treatment options, exposure to UV rays will undo all of your progress. Choose a sunscreen with an SPF of 30 or higher and preferably with Zinc or Titanium and reapply throughout the day as needed.
- Hydroquinone: Known as the principal component/ingredient of a fading cream, hydroquinone can be purchased over-the-counter and is considered to be one of the most effective methods for reducing the appearance of dark spots. For patients who are experiencing more severe cases of melasma, your dermatologist can provide you with a high-strength hydroquinone cream, or one that includes additional ingredients such as tretinoins and corticosteroids.
- Chemical Peels: Some melasma patients have success with chemical peels when used in combination with the treatments mentioned above. Together, these treatments can speed up the fading of dark patches. Your dermatologist will determine what level of peel works best for your skin; however, it is best to start with gentle peels. Peels work to remove dead skin cells, allowing treatment creams to penetrate deeper into the skin.
- Laser Treatments: Laser treatments are the most expensive treatments for melasma. A laser treatment aims to encourage cell turnover. Cell turnover helps to even overall skin tone.
Do You Need Help Managing Melasma
Melasma can be frustrating and challenging to manage on your own. With the help of a dermatologist and good skincare habits, patients can significantly reduce the appearance of melasma and prevent the darkening of their current melasma patches. Regular use of an SPF, in combination with prescription fading creams and chemical peels, can deliver great results to many patients. It is important to note that not all patients will achieve the same results.