Here, we will delve into what melasma is, its causes, common treatment options, and tips for living with melasma to improve your quality of life.

Melasma is a relatively common condition affecting the skin; it is characterized by the development of brown or gray patches on the skin.

This condition typically affects the face, with patches most commonly forming on the cheeks, forehead, upper lip, and chin. However, melasma can also affect other sun-exposed areas of the body, such as the forearms and neck.

The patches of melasma are usually symmetrical, meaning they occur on both sides of the face in a similar pattern. They are irregularly shaped and can vary in size and intensity.

The color of melasma patches can range from light brown to dark brown or even grayish. The patches are generally flat and do not cause any texture changes in the skin.

Melasma is often more noticeable in individuals with darker skin tones, but it can affect people of all ethnicities. It is more common in women than men; hormonal changes, particularly during pregnancy or while taking hormonal contraceptives, can trigger or worsen melasma.

Additionally, prolonged sun exposure and a genetic predisposition can contribute to the development of melasma.

Melasma most commonly occurs on the face. The specific areas of the face where melasma is frequently found include:

• Cheeks: Melasma patches can appear on the cheeks, often in a symmetrical pattern on both sides of the face.
• Forehead: The forehead is another common area for melasma patches to develop. They may extend across the forehead or be concentrated in certain areas.
• Upper Lip: Melasma can affect the upper lip, resulting in dark patches in that area.
• Chin: Some individuals with melasma may notice patches on the chin, either alone or in combination with other affected areas.
• Other areas of the body that are exposed to the sun, such as the forearms and neck, can also be affected by melasma, although it is less common in these areas.

It is important to remember that melasma can vary from person to person, and the distribution and severity of patches may differ. The specific areas affected can depend on factors such as sun exposure patterns, individual skin characteristics, and hormonal influences.

Melasma can be caused by a combination of factors, including:

• Hormonal changes: Fluctuations in hormone levels, particularly during pregnancy or while taking hormonal contraceptives, can trigger melasma. Hormones like estrogen and progesterone stimulate the production of melanin, leading to the formation of melasma patches.
• Sun exposure: Ultraviolet (UV) radiation from the sun is a significant contributing factor to melasma. Sun exposure stimulates the activity of melanocytes, the cells that produce melanin, leading to an uneven distribution of pigment and the development of melasma patches. Sunlight can worsen existing melasma and increase the risk of its recurrence.
• Genetic predisposition: Individuals with a family history of melasma are more likely to develop the condition themselves. Genetic factors related to melanin production and distribution may contribute to an increased susceptibility to melasma.
• Ethnicity: Melasma is more commonly observed in individuals with darker skin tones, such as those of Hispanic, Asian, African, or Middle Eastern descent. People with more melanin in their skin have a higher risk of developing melasma.
• Hormone-related medications: Certain medications that affect hormone levels, such as hormonal contraceptives or hormone replacement therapy (HRT), can trigger or worsen melasma.
• Cosmetics and skincare products: Some cosmetics and skincare products, especially those containing irritants or sensitizing ingredients, may contribute to the development or aggravation of melasma in some individuals.
• Medical conditions: Certain medical conditions, such as thyroid disorders or hormonal imbalances, may increase the likelihood of developing melasma.
• Tanning beds: Tanning beds emit ultraviolet (UV) radiation, similar to sunlight, which can stimulate the activity of melanocytes and increase the production of melanin in the skin. Regular use of tanning beds can contribute to the development or exacerbation of melasma, particularly in individuals who are already predisposed to the condition.

It is important to note that the exact interplay and relative importance of these factors may vary from person to person. 

The treatment of melasma aims to lighten the dark patches and achieve an even skin tone. While melasma cannot be cured completely, various treatment options are available to manage the condition effectively.

Treatment approaches may vary based on the severity of melasma, individual skin characteristics, and other factors. It is recommended to consult with an aesthetic physician to determine the most suitable treatment plan.

Some common treatment options for melasma include:

• Sun Protection: Sunscreen and sun protection are crucial in managing melasma. Broad-spectrum sunscreen with a high sun protection factor (SPF) should be applied daily, even on cloudy days. Physical sun protection measures like wearing wide-brimmed hats and seeking shade are also essential to prevent melasma from worsening.

• Topical Treatments: Prescription creams containing ingredients such as hydroquinone, tretinoin, corticosteroids, or azelaic acid are commonly used to lighten melasma patches. These creams work by reducing the production of melanin or accelerating skin cell turnover. They are typically applied to the affected areas as directed by an aesthetic physician.
• Chemical Peels: Superficial chemical peels, often using ingredients like glycolic acid or salicylic acid, can help exfoliate the skin and lighten melasma patches. Multiple sessions may be required to achieve desired results. Chemical peels should be performed by an aesthetic physician or skincare professional.
• Microdermabrasion: This treatment involves exfoliating the outer layer of the skin using a device with a diamond-tipped wand or fine crystals. It can help improve the appearance of melasma by removing dead skin cells and promoting skin renewal.
• Laser and Light Therapies: Certain laser and light-based treatments, such as intense pulsed light (IPL) or fractional laser resurfacing, can be used to target and reduce melasma pigmentation. These treatments work by breaking down excess melanin in the skin. Multiple sessions may be necessary, and they should be performed by qualified professionals.
• Combination Therapy: In some cases, a combination of different treatments may be recommended to achieve optimal results. This could involve a combination of topical creams, chemical peels, and laser or light therapies tailored to the individual’s needs.

It is important to note that results may vary among individuals, and it may take time to see visible improvements. Consistency in treatment and adhering to sun protection measures are key to managing melasma effectively.

Regular follow-up visits with an aesthetic physician are essential to monitor progress and make any necessary adjustments to the treatment plan.

Living with melasma can be challenging, but there are steps you can take to improve your quality of life and manage the condition effectively.

Here are some tips for living with melasma:

• Sun Protection: Protecting your skin from the sun is crucial in managing melasma. Use a broad-spectrum sunscreen with a high SPF daily, even on cloudy days. Apply sunscreen generously and reapply every two hours, especially if you are outdoors. Wear wide-brimmed hats, sunglasses, and protective clothing to minimize sun exposure.
• Gentle Skincare Routine: Use mild, non-irritating cleansers and moisturizers suitable for your skin type. Avoid harsh scrubs or abrasive products that can aggravate melasma. Opt for skincare products that are specifically formulated for hyperpigmented skin or recommended by your aesthetic physician.
• Makeup and Camouflage: Cosmetics can be used to conceal melasma patches and even out skin tone. Look for makeup products labeled as “non-comedogenic” or “non-acnegenic” to avoid clogging pores. Choose mineral-based or light-reflecting formulations that can provide coverage without exacerbating melasma.
• Seek Professional Advice: Consult an aesthetic physician experienced in treating melasma. They can provide personalized recommendations based on your specific condition. Regularly follow up with your aesthetic physician to monitor progress and make any necessary adjustments to your treatment plan.
• Be Patient and Consistent: Treating melasma takes time, and results may not be immediate. It is important to be patient and consistent with your treatment plan. Follow the instructions provided by your aesthetic physician and adhere to the prescribed skincare routine. Understand that improvement may happen gradually over weeks or months.
• Emphasize Self-Care: Managing stress levels and practicing relaxation techniques can be beneficial for your overall well-being and potentially help in managing melasma. Engage in activities that promote self-care and prioritize your mental and emotional health. Seek support from loved ones or consider joining support groups for individuals living with melasma.
• Consider Lifestyle Adjustments: Certain lifestyle factors can potentially worsen melasma. Avoid excessive heat, as it can trigger melasma flare-ups. Be cautious with hot showers, saunas, and steam rooms. Quit smoking if you’re a smoker, as smoking can affect the health and appearance of your skin.
• Dietary Considerations: While there is limited scientific evidence linking specific foods to melasma, a balanced and healthy diet can support overall skin health. Include a variety of fruits, vegetables, whole grains, and lean proteins in your diet. Stay hydrated by drinking an adequate amount of water daily.

Remember, each person’s experience with melasma is unique, and what works for one may not work for another. It is important to consult with an aesthetic physician for an accurate diagnosis and personalized treatment plan.

With proper care, management, and lifestyle adjustments, you can improve your quality of life while living with melasma.

Melasma is a common skin condition characterized by the development of brown or gray patches on the face and other sun-exposed areas. It is often triggered by hormonal changes and sun exposure.

While it cannot be cured, various treatments, such as topical creams, chemical peels, and laser therapies, can help manage the condition. Sun protection and gentle skincare are essential.

Living with melasma requires patience, consistency, and self-care. Each person’s experience with melasma is unique, and what works for one may not work for another. It is important to consult with an aesthetic physician for an accurate diagnosis and personalized treatment plan.

Cleveland Clinic. Melasma. Available from: https://my.clevelandclinic.org/health/diseases/21454-melasma. Accessed June 8, 2023.

Healthline. Melasma: Symptoms, Treatment, and More. Available from: https://www.healthline.com/health/melasma#risk-factors-and-causes. Accessed June 8, 2023.

National Center for Biotechnology Information. StatPearls [Internet]. Melasma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459271/. Accessed June 8, 2023.

American Academy of Dermatology Association. Melasma: Causes. Available from: https://www.aad.org/public/diseases/a-z/melasma-causes. Accessed June 8, 2023.