Melasma

Created: 09.01.2025

Updated 09.01.2025

Approved by: Consultant Dermatologist, Dr James Denny

What is Melasma?

Melasma is a common skin condition characterised by dark, uneven patches on the skin. The condition often occurs on the face, especially on the cheeks, forehead, nose, and upper lip, but can also appear on other parts of the body that are exposed to sunlight.

Melasma is not only a cosmetic issue but can also deeply affect the self-esteem of individuals suffering from it. Although it predominantly affects women, especially those with darker skin tones, it can occur in anyone regardless of gender or race.

Why do you get Melasma?

A variety of factors can contribute to the onset of melasma:

1. Sun exposure: One of the primary causes is sunlight exposure. UV rays stimulate melanocytes, the cells responsible for producing melanin which gives skin its colour, leading to increased pigmentation and the development of dark spots that evolve into melasma.
2. Hormonal fluctuations: Hormonal changes, often seen during pregnancy, in women on birth control, or undergoing post-menopausal hormone therapy, can trigger this condition. As a result, melasma is frequently observed in women of childbearing age and those who are pregnant.
3. Other factors: Heat, photosensitive medications, and various other elements can also instigate melasma.

It's crucial to understand these triggers to prevent or manage this skin condition effectively.

What are the treatments?

Melasma, though a harmless skin condition, can pose significant cosmetic concerns for many. Here are the various treatments available for those looking to mitigate its appearance.

1. Sun protection: This is a primary step in reducing further darkening of the skin.
2. Skincare products: There are numerous products tailored to treat melasma.
3. Contraceptive choices: Sometimes, a different type of contraceptive might help in preventing the recurrence of melasma.
4. Topical medications: Various topical treatments may be considered under the recommendation of a doctor, such as Azelaic acid 20% cream, topical 0.1% tretinoin cream and Pigmanorm - all of these must be used under the guidance of a dermatologist to prevent unexpected outcomes.
5. Oral mediations: Recently oral Tranxemic acid has show to be of benefit but this medication requires counselling and possible blood tests before considering.

It's essential to be aware of any cosmetics that may irritate the skin and exacerbate the condition. If melasma or any other skin concern is suspected, the best course of action is to consult with a dermatologist or skin specialist. They can offer an accurate diagnosis and curate a treatment plan tailored to individual needs.

What is the prognosis?

Often, melasma resolves on its own or significantly diminishes. However, it might recur during subsequent pregnancies or due to changes in contraceptive methods. In some cases, if it reappears, it may persist for several years or even become a lifelong condition.