Skinformation: Melasma


What is melasma?

Melasma is a type of hyperpigmentation. It is a common skin condition that causes dark, discoloured patches on your skin.

The skin discoloration doesn’t do any physical harm, but you may feel self-conscious about the way it looks.

There are three types of Melasma: 

  • Epidermal melasma affects the top layer of skin and the hyperpigmentation is brown with well-defined borders. 
  • Dermal melasma affects the deeper dermal layers of skin and is characterised by blue-grey patches. 
  • Mixed melasma (a combination of epidermal and dermal) shows as a brown-grey pigment.

Symptoms of melasma

Melasma is characterised by patchy skin that is darker than your usual skin colour. It typically occurs on the face and is symmetrical, with matching marks on both sides of the face.

Brownish colored patches usually appear on the:

  • cheeks
  • forehead
  • bridge of the nose
  • chin
  • neck and forearms – ocassionally

What is melanoma caused by?

Genetic predisposition is considered one of the main causes implicated in melasma development. It is also thought that melasma affects more pigmented phenotypes i.e darker-skinned individuals.

UV irradiation (exposure to the sun) is also considered to play a major role in melasma development. UV irradiation stimulates melanogenesis which is the complex process by which the pigment melanin is produced. An overproduction of melanin leads to hyperpigmentation conditions such as melasma.

How is melasma diagnosed?

A visual exam of the affected area is often enough to diagnose melasma.

A special kind of light held up to your skin is one technique used to detect melasma. It’s called the wood lamps examination. This type of examination allows for testing of bacterial and fungal infections and helps your doctor determine how many layers of skin the melasma affects.

For more serious skin conditions, they might also perform a biopsy, which involves removing a small piece of the affected skin for testing.

How do you treat melasma?

There are creams your healthcare professional can prescribe that can lighten the skin. They might also prescribe topical steroids to help lighten the affected areas. If these don’t work, chemical peels, dermabrasion, and microdermabrasion are possible options. These treatments strip away the top layers of skin and may help lighten dark patches.

It’s important to remember that these procedures don’t guarantee that melasma won’t come back, and some cases of melasma can’t be completely lightened.

To decrease your risk of getting melasma minimise your sun exposure and wear sunscreen daily.

Tranexamic acid is thought to be extremely useful in treating melasma. This study tells us that oral tranexamic acid is a promising new treatment for moderate and severe recurrent melasm. However it’s still too early to know how well this works as a skin lightening treatment for hyperpigmentation. More research is needed before it can be recommended.

Cetyl tranexamate mesylate is a tranexamic acid derivative. A recent study tells us that CTM successfully improves the overall facial skin tone and can help treat dark spots and redness. It also says that CTM is well tolerated by the skin, especially in serum form. This could be a great way to include melasma combating ingredient in your daily skincare routine.

For the right way to treat melasma you will need to see a doctor who can prescribe the best way for your to move forward.

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