Melasma Intervention: Effective treatments to slow down melasma

Pigmentation disorders are very common especially among adults. Each type can be determined by the appearance of spots or patches of skin discoloration. Because most pigmentation flaws often share a similar symptom, it is easy to mistake one for another and this can cause a problem particularly when the condition is melasma, a chronic condition that requires the attention of skin experts. There are various treatments available to effectively slow down melasma and this write up serves as your guide on how to hinder this unflattering skin discoloration from invading your face.

How to identify melasma

Melasma can be identified by patches of skin discoloration that are darker than the natural colour of your skin. It usually develops on the face and their appearance is identical on both sides of the face. Melasma can form on these areas of the face:

Cheeks
Chin
Forehead
Upper lip
Nose Bridge

Melasma may also affect the forearms and neck or other areas of the body that are usually exposed to the sun.

To know whether the skin pigmentation is indeed melasma, a visual exam is initially conducted by a dermatologist. Further tests may be recommended to rule out other conditions. A test that is specifically done to determine melasma is called “Wood’s lamp examination.”

Wood’s lamp examination uses a special light that is hovered on the skin to check for any infections. It can also show how deep it goes into the skin.

Aside from Wood’s lamp examination, your doctor may also require you to undergo a skin biopsy. This test involves taking a small sample of your skin and submitting it for lab analysis to rule out other skin conditions or diseases.

Causes of melasma

The main cause of melasma is still unknown although this chronic condition has been linked to certain types of people, such as those who:

Are often exposed to the sun without proper UV rays protection
Are sensitive to estrogen and progesterone or hormonal changes
Are taking medications that may trigger melasma, such as anti-seizure medicines, birth control pills, and antibiotics, retinoids, or blood pressure medications that can make the skin more sensitive to sun exposure
Are undergoing stress
Have been diagnosed with thyroid disease
Have darker skin tones

Certain people are more at risk of developing melasma than others:

Those who have medium or dark skin color
Those who have melasma in their bloodline
Women who are 20 to 40 years old

Treatments for melasma

Successful treatment of melasma or any pigmentation disorder starts with an accurate diagnosis. Hence, it is important that the skin is thoroughly checked by a medical professional that specialises in skin health. After ruling out all other skin conditions and accurately diagnosing melasma, you and your doctor can start to plan for your treatment, which can include:

Chemical peels
Laser and light treatments
Microneedling
Topical and oral medications

Chemical peels.

This type of melasma treatment uses substances like alpha-hydroxy acids (AHA), glycolic acid, and salicylic acid. These chemicals are applied on the surface of the skin where the pigmentation is located. The substances then work to peel the superficial layer of the skin, making the pigmentation lighter. The results of chemical peels are not permanent as the treatment only removes the surface layer of the skin and does not do anything to stop the production of excess pigments that happens in the deeper layers of the skin.

Laser and light therapies. Laser and light therapies use energy-charged light to target the pigments in the skin and break them down into micro pieces that are then absorbed by the body and released naturally. Q switch laser is a popular procedure that improves the skin’s appearance. Although this procedure can work in addressing melasma pigmentation, some may have adverse reactions to the treatment. There is a risk of post-treatment relapse or developing post-inflammatory hyperpigmentation when laser or light treatments become excessive. Like chemical peels, the results are also temporary as this treatment does not solve the root cause of melasma.

There are several types of lasers and light treatments that can be used to treat melasma including:

Fractional laser
PicoSure laser
Intense Pulsed Light (IPL)
Q Switch laser

Microneedling.

This procedure makes use of fine needles that prick through the skin, creating microscopic tears. New skin cells then regenerate as the skin heals and makes the skin tone appear more even on the surface.

Topical and oral medications. Topical skin lightening medications are the most common treatment recommended for melasma. These medications have powerful active ingredients including:

Azelaic acid
Cysteamine
Hydroquinone
Kojic acid
Niacinamide
Rucinol

Oral medications use tranexamic acid, which is believed to help lessen the production of pigments by reducing any surplus of blood vessels in the skin.

Melasma prevention

Unfortunately, melasma cannot be prevented completely if the factors that cause their existence is due to a person’s skin tone, hormones, or genes, but you can apply preventative measures that can help your melasma from worsening.

Slowing down melasma

Melasma is a chronic condition and can go on for months even with treatments. Appearing flawless despite having this condition can be achieved by wearing camouflage make up. To do this, apply your melasma medication first, followed by sunscreen, and then your makeup. It is important that you wear makeup that will not cause further skin irritation, so as not to trigger any condition that can worsen your melasma.

Using protective clothing should be done daily, particularly if you are often under the heat of the sun for a long period of time. Always apply sunscreen on the areas of your face and body that are exposed to the sun. Broad-spectrum tinted sunscreens that contain iron oxide have been found to lower the skin’s production of pigment among melasma patients. Avoid tanning beds as this can make your melasma even more darker.

If you are pregnant, or taking birth control pills and/or other medications that can increase the risk of developing melasma, inform your dermatologist so they can give you guidance on a work around that does not complicate your melasma as well as your overall health.