What Causes Melasma and How is it Treated?

What is Melasma?

Melasma is a common acquired increase of pigmentation that occurs exclusively in sun-exposed areas. Brownish in color, it is exacerbated by sun exposure, pregnancy, oral contraceptives, and certain anti-epilepsy drugs.

Melasma is reasonably common, especially in women of child-bearing age. However, up to 10% of cases have been reported in males. While all races are affected, there is a prominence among Latinos and Asians. Melasma is more apparent during and after periods of sun exposure and less obvious in winter months, when sun exposure is lacking.

Melasma presents itself in one of the three usually symmetrical facial patterns. The most common is a central facial pattern involving the cheeks, forehead, upper lip, nose, and chin. Less common are the malar pattern, involving the cheeks and nose, and the mandibular pattern, involving the ramus of the mandible (the side of the cheeks and jaw line). Melasma also occurs on the forearms, but this is rare.

Melasma has been considered to arise from pregnancy, oral contraceptives, endocrine dysfunction, genetic factors,medications, nutritional deficiency, hepatic dysfunction, and other factors. The majority of cases appear related to pregnancy or oral contraceptives. The infrequency of melasma in postmenopausal women on estrogen replacement suggests that estrogen alone is not the cause.

In more recent experience, combination treatment using estrogen plus progestational agents is being used in postmenopausal women, and melasma is being observed in some of these older women who did not have melasma during their pregnancies. Sun exposure would appear to be a stimulating factor in predisposed individuals. Although a few cases within families have been describe, melasma should not be considered a heritable disorder.

Treatments for Melasma

Successful treatment of melasma involves the triad of sunblocks, bleach and time. According to research done by Dr. Mark B. Taylor, a particular type of alpha hydroxy acid, known as mandelic acid has been shown to improve a type of melasma that is often resistant to topical treatments, dermal melasma. Because this alpha hydroxy acid is also safe on Latino and Asian skin, it can also be considered as a possible treatment for melasma.

Sunscreen, however, is the most important factor. Without daily use of opaque sunscreen, treatment will fail (a broad-spectrum formulation with an SPF over 30 plus cover up is adequate). Bleaching preparations include 2 or 4% hydroquinone-containing creams or gels and 3% hydroquinone solution. A skin bleaching solution available with Glycolic Acid 2% hydroquinone (Glycolic Acid may cause hyper-pigmentation in those with darker skin types, such as Asian or Latino skin). The higher concentrations may carry more risk of contact irritation, but this may depend on the individual and base.

Simultaneous use of topical tretinoin gel, 0.025%, is usually also required.

Normally up to 2 months are required to begin to initiate response and up to 6 months to complete the process. Once epidermal melasma is cleared and is no longer apparent with Wood's lamp examination, the hydroquinone and tretinoin should be discontinued. However, the opaque sunscreen should be continued through at least one summer season to reduce the risk of recurrence. Dermal melasma that does not respond to the above treatment, at the present time cannot be treated, with the exception of mandelic acid solutions. Often, melasma will slowly resolve following childbirth or upon discontinued use of oral contraceptives.

Pixel is a laser treatment that removes a small portion of the skin's surface, leaving most of the skin in its normal state. The body creates new, healthier skin in response to the stimulation smoothening wrinkles, scars, reducing pigment and acne. This technique makes the healing process much quicker and enables patients to get back to their normal life styles sooner.

Preserving youthful skin is easier than trying to repair skin that has been abused for decades. The Natural Skin Care Therapies available at Pinewood Natural Health Centre are an elegant way to restore and maintain that younger look, gently and naturally for many years.

Our natural products are grown organically and are selected for their beautifying and therapeutic properties. Natural ingredients are potent and give beautiful lasting results for a clear, balanced, revitalized and glowing complexion. We address a variety of skin concerns including: premature aging and wrinkling, sun damage, acne, and loss of vitality, tone and radiance. The cure comes from nature with treatments and products that impart health and beauty to your skin.

At Pinewood Natural Health Centre, we help you achieve beautiful and healthy skin by making the correct medical diagnosis for your skin type and by prescribing perfectly the products you must apply at home to ensure a proper care for your skin. Come to Pinewood Natural Health Centre and experience what nature has offered to maintain your health and beauty.

If you have concerns about melasma and would like to book a no-obligation consultation, call one of our clinics today -areas surrounding: Mississauga, Etobicoke, North York, Scarborough, Markham, call our Toronto Clinic: (416) 656-8100, for Pickering, Whitby, or Oshawa,call our Ajax Clinic: (905) 427-0057.