Many patients visit Mid-Atlantic Skin to treat melasma, which is a medical skin condition in which dark brown or gray patches appear on the face–specifically areas like the forehead, cheeks and upper lip.
Melasma is very common and is due to excessive pigment (melanin) collecting in the skin. The dark melasma patches usually have distinct edges and are symmetrical (similar on both sides of the face).
When melasma occurs during pregnancy, it is often referred to as “chloasma” or the “mask of pregnancy.”
Melasma occurs in up to six million American women and although patients may be concerned with the appearance of the dark patches, melasma is a harmless condition that causes no other health problems.
What Are the Types of Melasma?
Melasma can be categorized as “epidermal,” “dermal,” or mixed.
Epidermal melasma means the pigment (melanin) is in the more superficial layers of the skin called the epidermis.
Dermal melasma means that the pigment is in the deeper layers of the skin. This distinction is important because epidermal melasma responds more quickly to treatment.
What Are the Risk Factors for Melasma?
Although melasma can occur in men, it is most common in women, especially in women of Hispanic or Asian ancestry. If your relatives had melasma, you are also at greater risk of developing melasma.
Women are also at greater risk of developing melasma if they are pregnant, take birth control pills, or take hormone replacement therapy.
Sunlight is essential to the development of melasma. People at risk of developing melasma will notice the patches becoming darker following exposure to sunlight.
Treatment Options for Melasma
Treatment results vary greatly among individuals. Your recommended treatment will depend largely on your type of melasma, dermal or epidermal.
According to the American Academy of Dermatology, one of the most common treatments for melasma is sun protection.
This means wearing sunscreen every day and reapplying the sunscreen every two hours. We also recommend wearing a wide-brimmed hat when you are outside because sunscreen alone may not give you the protection you need.
Some people with epidermal melasma experience rapid improvement within four to eight weeks of starting treatment, while others may find that improvement takes many months.
It may take time to respond to treatment, so be patient.
Medications for Melasma
Topical retinoids, such as tretinoin, are a form of vitamin A and may be used to increase the turnover of skin cells, speeding the growth of lighter colored skin.
Azelaic acid (Azelex®, Finacea®) may help to slow the activity of melanocytes, the cells that make the dark pigment in the skin.
Tri-Luma® is a prescription-only medication that has been FDA-approved cream for the treatment of melasma. Tri-Luma combines three ingredients into one topical medication that is used once-a-day.
The ingredients include tretinoin, hydroquinone, and fluocinolone acetonide. Fluocinolone acetonide is a topical corticosteroid (“steroid cream”) that reduces irritation and may also help skin lightening.
To learn more about treating melasma or to get checked for the condition, visit Mid-Atlantic Skin at one of our three convenient locations in Waldorf, Leonardtown and California, MD.