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Melasma explained

Melasma Explained

If you have noticed that your skin’s colour does not look quite right and seems patchy, you may be suffering from a condition called Melasma. It can make you feel quite self-conscious, which could lead to your self-esteem being affected. It’s not a term that you hear every day, but for the people who suffer, it can be a bit challenging.

However, challenging does not mean insurmountable. There are solutions. So, here we will explore exactly what melasma is, any questions that you may have about the condition, and most importantly what treatment options are available.

What exactly is Melasma?

A definition is always a useful place to start. Melasma is caused by an overproduction of melanin in the skin that causes grey and brown patches to appear predominantly on the face.

What causes Melasma?

Melasma can be triggered by a number of factors. Here we will discuss them in a bit of detail.

Hormonal changes- This is believed to be one of the key triggers for melasma. We see evidence of this since many women develop melasma during pregnancy when hormone levels are elevated because of the baby. Statistics have shown that women who have undergone hormonal therapy or used contraceptive pills are at a greater risk of developing melasma.

Genetics- Sadly, you can’t fight your genes. If there are people in your family who suffer from Melasma. There is a possibility that you could develop it as well.

Exposure to sun- As we know sun exposure can wreak havoc on our skin. Hence the huge market for sunscreen. The sun can trigger melasma just in the same way it triggers sun spots and age spots. Whether you are at risk for Melasma or not, protecting your skin from harmful UV rays is always a good idea.

Certain Medications- This point is mentioned last since the possibility of this happening is extremely remote. On a rare occasion, thyroid and epilepsy medication may contribute to melasma.

Who is at risk for Melasma?

Both men and women can get Melasma. Unfortunately, it is a condition that affects mostly women who are in their 30s or 40s.

How is Melasma diagnosed?

We all know that proper diagnosis is crucial to effective treatment. Melasma can usually be diagnosed by your doctor simply looking at your skin. Alternatively, he or she may view your skin under a medical instrument called a Wood’s light.

However, to definitively rule out another condition, your doctor may take a small skin biopsy. Don’t worry, it’s a very small superficial skin sample and his sample will then be sent to the lab for testing.

What are the commonly affected areas?

Melasma is for the most part a facial pigmentation issue. It can present on the nose bridge, cheeks, upper lips, and the forehead.

However, melasma has been known to appear in other parts of the body as well. Namely the shoulders, neck, and forearms.

Is there a cure for Melasma?

Unfortunately, there is no cure for melasma. However, there are quite a few treatment options to help manage the condition.

What treatments are available for Melasma?

There are quite a few options when it comes to treating melasma. We will look at each one, in turn, starting with the least invasive to some of the more intense measures.

  1. Time
    So, this one is based on the premise if you are willing to wait, over time the brown or gray patches on your skin will fade. However, this is a lengthy process sometimes taking quite a number of years. Most women are not prepared to wait that long.
  2. Sun Screen
    We cannot stress this measure enough! Sunscreen is crucial in the fight against melasma. Your doctor will recommend that you use a broad-spectrum sunscreen with a high SPF and protects you from both UVA and UVB rays.
    Of course, if you can use one with highest SPF protection that would be even better.
    You are also encouraged to be consistent when using your sunscreen. Those who use sunscreen on a regular basis lessen their risk of developing melasma significantly! Reapplication during the day is also important.
  3. Combination cream
    This cream provides a three-prong treatment approach. There are quite a few formulas on the market to choose from. These creams are a safe and accessible treatment for melasma.
  4. IPL
    Intense Pulse Light is used to treat several dermatological issues. However, results have been somewhat hit and miss and in certain cases, it has actually aggravated melasma.
  5. Chemical Peels
    This treatment is often viewed with a bit of consternation. A chemical is applied to your face for a specific amount of time and that layer of skin peels. The melasma-related pigment comes off in the exfoliation. However, chemical peels are not an exact science. Everyone’s skin does not react the same.
    Depending on your sensitivity, chemical peels can do significant damage to several layers of your skin. On the other hand, Some people see little to no improvement in the affected area.
  6. Oral medications There are oral medications that are used to treat heavy menstrual periods. Apparently, it also helps treats melasma.
    However, the treatment plans differ in dosage amount and duration. The duration can range to be as short as 6 weeks and depending on the severity of your melasma as long as 6 months.
  7. Lasers There are quite a few types of lasers that are used to treat melasma:
    Q-switched lasers
    Fractionated lasers
    Ablative lasers

Even though they all utilize slightly different methods, their goal is to remove the melanin causing the irregular pigmentation from the skin. While each one may help treat melasma, none are a long-lasting solution. You should also be aware that laser treatment can trigger Post-Inflammatory Hyperpigmentation.

If it’s not Melasma, what could it be?

There are other conditions that can mimic the appearance of Melasma:

  • Sunspots
  • Allergies
  • Freckles
  • Hori’s Naevus

So before you start treatment you should seek a proper diagnosis. Managing melasma requires consistency and patience. You may also need to explore the various options to find the one that works best for you.

Speak to your doctor to find the treatment that is right for you.


  1. Handel, A. C., Miot, L. D., & Miot, H. A. (2014). Melasma: a clinical and epidemiological review. Anais brasileiros de dermatologia89(5), 771–782.
  2. Sarma, N., Chakraborty, S., Poojary, S. A., Rathi, S., Kumaran, S., Nirmal, B., Felicita, J., Sarkar, R., Jaiswal, P., D’Souza, P., Donthula, N., Sethi, S., Ailawadi, P., & Joseph, B. (2017). Evidence-based Review, Grade of Recommendation, and Suggested Treatment Recommendations for Melasma. Indian dermatology online journal8(6), 406–442.

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