Melasma Treatment

Melasma is a skin disorder that causes dark spots or patches, mostly on the face. These spots can be brown, greyish brown, tan, or bluish-grey and may resemble freckles. This condition happens more often in women than men. Pregnant women get it the most. According to an estimate, 15% to 50% of pregnant women worldwide get melasma. That is why it is also known as the “mask of pregnancy.”

Melasma is usually a temporary skin condition that subsides on its own. However, in some cases, it may last for years.

Melasma is not usually a sign of a severe health condition. It doesn’t turn into a serious or life-threatening disease either. But, having visible melasma spots can affect your facial aesthetics, potentially leading to emotional distress and lower self-esteem.

What are the Symptoms of Melasma?

Melasma is identified by blotchy, hyper-pigmented patches that appear darker than your skin tone. They develop mostly on the facial areas like cheeks, forehead, nose’s bridge, and chin. In rare cases, it may occur on the neck and arms. Other common signs and symptoms include the following

• Melasma patches are often symmetric, i.e., they usually develop on both sides of the face. But in some cases, it may only appear on one side.
• They can be more prominent in some areas than others (e.g., they might be more noticeable on the cheeks, nose, or jawline than in other facial areas).
• They may cover a sizeable facial skin area, appearing as one large patch or several small spots.

Types of Melasma

Melasma can be classified into three types based on the melanin deposition in the skin layers.

• Epidermal Melasma: This type of melasma is identified by a well-defined border and the dark brown color of the spots. It usually appears more prominently under the Wood’s lamp (a tool that emits UV-A light or blacklight).
• Dermal melasma: This type is usually blue-grey or light brown and generally has an ill-defined border. The visibility of dermal melasma doesn’t become enhanced when viewed using Wood’s lamp.
• Mixed Melasma: This type is the most common and is usually identified by a combination of dark or light brown and bluish-grey patches. When viewed under black light, it may show mixed patterns.

Causes and Risk Factors

Exactly what causes melasma is yet to be established. However, researchers have found that in people suffering from melasma, the cells that give the skin its color, called melanocytes, are often more active than usual. This strengthens the theory that melasma may develop when something causes melanocytes to go into overdrive.

Some possible melasma triggers are listed below

• Pregnancy: The risk of melasma is the highest in pregnant women. Experts believe this may be due to a substantial increase in estrogen and progesterone hormones.
• Sunlight: Exposure to the sun boosts melanin production in the body, increasing the risk of melasma. This explains why areas that get the most sunlight, like the face, neck, and arms, are more likely to develop melasma.
• Stress: Stress leads to higher levels of the hormone cortisol, possibly triggering melasma. However, more research is needed to establish stress as a major melasma trigger.
• Certain medications: Birth control pills, anti-seizure medications, and drugs that increase skin’s sensitivity to sunlight have been found to trigger melasma in some people.
• Tanning beds: Tanning beds expose the skin to more concentrated UV rays than sunlight. This can lead to higher melanin production, increasing the melasma risk.
• Thyroid disease: A problem with the thyroid has been found to increase the risk of melasma in some cases.
  Treatment-induced hormonal changes: Hormonal changes caused by hormone replacement therapy (HRT) or oral contraceptives may increase the melasma risk.

Besides pregnancy, the following factors are thought to be associated with a higher risk of melasma

• Being a woman aged between 20 and 40
• Having a medium or dark skin tone
• Having a close relative suffering from melasma

Diagnosis

Dermatologists use multiple measures to diagnose melasma. Here is a brief overview of some standard diagnostic techniques

• A clinical examination – This simple measure helps identify basic signs of melasma. It may involve using a dermatoscope to examine the affected area closely. The doctor may also inquire about the patient’s personal or family history to evaluate their overall susceptibility to developing melasma.
• Wood’s Lamp – This tool uses a black light to identify skin color changes and diagnose certain skin conditions. It may also help identify or classify melasma spots.
• Thyroid checkup – Your doctor may want to check your thyroid if you have dark, blotchy spots on your face. This is because there is a link between thyroid disease and melasma.
• Skin biopsy – Sometimes, the spots caused by melasma look like those from other skin conditions, so it can be hard to tell them apart. A skin biopsy can help identify the exact reason for dark spots on your skin.
  Melasma Area and Severity Index (MASI) – Clinicians may use this scoring system to determine the severity of melasma.

Treatment Options for Melasma

There is no cure available for melasma as yet. However, dermatologists prescribe clinical procedures and medications to manage this condition. The success of these treatments significantly depends on the practitioner’s expertise, so it is imperative to get melasma treatment from a highly qualified, skilled dermatologist.

Let’s briefly look at some of the most common treatment options for melasma.

Topical Creams

For patients with melasma, dermatologists often recommend creams that contain Hydroquinone (HQ). These creams work to even out the skin tone by reducing dark spots.

Other agents known to improve melasma appearance include the following

• Kojic acid
• Azelaic acid
• Topical steroids
• Retinoids
• Mequinol
• Glycolic acid
• Arbutin

Chemical Peels

Chemical peeling can be an effective option to reduce the appearance of melasma spots. This procedure involves applying a peeling solution to the skin, which exfoliates the top skin layer. Chemical peeling can effectively improve the appearance of epidermal melasma spots. However, this treatment may not be as effective for dermal melasma due to the higher concentration of pigmentation in the spots.

Microdermabrasion

Microdermabrasion generally involves using a handheld device that sprays tiny crystals onto the skin, exfoliating the top skin layer. This can help reduce dark spots and discolored patches, including the ones caused by melasma. Microdermabrasion often works more effectively when combined with oral or topical treatments.

Laser Treatment

Lasers may effectively treat melasma that doesn’t respond to topical creams and chemical peels. A laser therapy session involves directing a concentrated beam of laser light at the skin. This beam penetrates the top skin layer and stimulates cell renewal, potentially leading to an even skin tone.

Two of the most common lasers used for melasma treatment are

• Pico Lasers
• Fraxel (fractional) lasers
• Q-Switched ND: YAG (532 nm, 1064nm)
• 755 nm Q-switched alexandrite laser (QSAL)

At Dubai Cosmetic Surgery Clinic, we use Medica Pico Laser to treat melasma spots.

Before & After

No Guarantee, as the results may vary from person to person.

Melasma Treatment Cost in Dubai

The cost of melasma treatment is determined based on the type of treatment chosen. The average starting price of laser melasma treatment is AED 3500. You can consult with our dermatologists to know the price relevant to your case.

Why is Sun Protection essential for managing Melasma?

Sunlight can stimulate melanin production, potentially darkening the existing melasma spots and forming new melasma patches. Therefore, regardless of which treatment you get, protecting your skin from direct sun exposure is essential to manage your melasma effectively.
Your dermatologist will likely give you a set of guidelines for adequate sun protection. These guidelines may include the following

• Wear a wide-brimmed hat when going outdoors in the daytime.
• Use a broad-spectrum sunscreen of SPF 30 or higher.
• Use a sunscreen containing iron oxide, zinc oxide, or titanium oxide.

How can I permanently cure melasma?

Unfortunately, no treatments can guarantee a permanent cure for melasma. However, many treatments are available to manage the condition.

Can you treat melasma during pregnancy?

It is generally not advisable to treat melasma during pregnancy. This is because, in most cases, pregnancy melasma resolves after giving birth. Another reason is that some melasma treatments may not be safe during pregnancy.

Birth control pills causing melasma, what to do?

If you use birth control pills but are concerned about the higher risk of melasma, you can consider the mini-pill. It is a progestin-only pill that doesn’t contain estrogen. Its use is less likely to trigger melanin overproduction and cause melasma. That being said, speaking to your doctor before switching to this pill is essential.

Our Doctors

Schedule A Consultation

Don’t let melasma affect your facial aesthetics and dent your self-esteem. Discuss treatment options with our expert dermatologists at Dubai Cosmetic Surgery Clinic, who will guide you to regain a spotless, even complexion. For details, call +971 4 348 5575. To book a consultation online, fill out the form below.