Melasma is a common skin condition associated with sun-exposure and hormonal changes. It is caused by excess melanin production which leads to patches of hyperpigmentation.

Melasma hyperpigmentation is a common skin condition. It is characterised by the appearance of brown or grey-brown patches, mainly on the face. While anyone can get melasma, it is more common in women, particularly during hormonal fluctuations such as pregnancy or menopause, and in individuals with darker skin tones.

What is Melasma and What Does it Look Like?

Melasma is a type of hyperpigmentation where the skin produces too much pigment, resulting in dark, discoloured patches or spots. These areas of discolouration often develop gradually and are usually symmetrical, with matching marks on both sides of the face. The most common areas on the body affected by melasma are the cheeks, bridge of the nose, forehead, chin, and above the upper lip.

Melasma in Skin of Colour

Melasma is more common in individuals with darker skin tones, including those of Hispanic, Asian, Middle Eastern, and African descent who are more prone to hyperpigmentation. This is pigment rich skin complexions have more active melanocytes than lighter skin tones. When these melanocytes are stimulated, they can produce more melanin. This leads to the appearance of hyperpigmentation. The patches can be darker and more noticeable on skin of colour. Moreover, people with skin of colour are more likely to experience post-inflammatory hyperpigmentation, which can sometimes be confused with or worsen the appearance of melasma.

Melasma in Men

Whilst melasma is much more common in women, men are also affected. Approximately 10% of melasma cases occur in men. Similar to women, in men, it appears as dark, discoloured patches on the skin, usually on the face. Factors like sun exposure and genetics play a significant role in developing hyperpigmentation in men. Men with darker skin tones are more prone to this condition. Although it is commonly associated with hormonal changes in women, particularly during pregnancy, melasma can also occur in men. This supports the theory that sun exposure is a significant factor in the development of this condition.

What Causes Melasma

The exact cause of melasma is unknown. However, there is widespread belief that it occurs when the colour making cells in the skin, known as melanocytes, produce too much pigment (melanin). Several factors can trigger this over production of melanin:

  1. Sun Exposure: Ultraviolet light from the sun can increase melanin production causing hyperpigmentation. This is why melasma often worsens in the summer and improves during the winter months.
  2. Hormonal Changes: Melasma is sometimes described as the “mask of pregnancy” because it is common in pregnant women. This is due to raised levels of progesterone, oestrogen and melanocyte-stimulating hormone during the second and third trimesters. Some women may also develop it while taking birth control pills or hormone replacement therapy during menopause.
  3. Genetics: If melasma runs in your family, you’re more likely to develop it too. It often occurs in people with a family history of the condition.

While melasma mainly affects the face, it can also appear on other parts of the body exposed to the sun, like the neck and forearms. Rarely, it may appear on the back.

Melasma During Pregnancy and Menopause

Melasma is so common during pregnancy that it has its own name; chloasma. It affects up to 50% of pregnant women. Similarly, women going through menopause may also notice the appearance of these irregular patches due to hormonal changes.

Treating Melasma Hyperpigmentation

While melasma may fade over time, especially after pregnancy or after stopping hormonal contraception, many people require treatment to fully clear the condition. Treatment options usually require topical prescription creams. The most commonly used skincare products for melasma are hydroquinone and Tretinoin. When combined they offer an even more effective treatment for melasma. Other skin lightening agents such as Arbutin, Retinol and Kojic acid maybe used. Professional treatments like laser and chemical peels are also an option.

At City Skin Clinic, we provide personalised skincare using prescription strength ingredients to manage and treat melasma in suitable patients. Always remember that the best treatment for melasma begins with sun protection. Incorporating a high SPF sunscreen into your daily skincare routine is vital.

We are here to guide you on your journey to clearer and more healthy skin. Book an online appointment with our doctors at City Skin Clinic, and let us help you manage and treat your melasma with personalised skincare.

Frequently asked questions

Melasma is primarily caused by an overproduction of melanin, the pigment that gives our skin its colour. This overproduction can be triggered by several factors, including sun exposure, hormonal changes (such as pregnancy or menopause), and genetics.

Melasma is usually diagnosed through a visual examination of the skin by a healthcare professional. In some cases, a device called a Wood's light might be used to examine the skin more closely. In rare instances, a small skin biopsy may be taken to rule out other skin conditions.

There are various treatment options for melasma. Topical creams containing lightening agents like hydroquinone, Tretinoin, corticosteroids, or azelaic acid can be used to gradually fade the patches. In-office procedures like chemical peels, microdermabrasion, or laser treatments can also help, although they should be approached with caution as they can sometimes worsen melasma if not done correctly.

Both melasma and hyperpigmentation involve an overproduction of melanin leading to dark patches on the skin. However, melasma is typically triggered by hormonal changes and sun exposure, often appears symmetrically on the face, and is more prevalent in women. Hyperpigmentation can be caused by various factors including injuries, inflammation, acne, or certain medications, and can occur anywhere on the body.

While it may not always be preventable, especially if you are genetically predisposed, you can take steps to reduce your risk of developing melasma. These include avoiding excessive sun exposure, wearing a broad-spectrum sunscreen of at least SPF 30 every day, and discussing any concerns about medications linked to melasma with your doctor.

Melasma is not necessarily permanent, but it can be stubborn to treat and requires consistent management. In some cases, melasma may fade over time, especially if it's related to a temporary hormonal change like pregnancy. However, for many, melasma is a chronic condition that requires long-term management.

If you're pregnant and dealing with melasma, it's important to use sun protection consistently. A pregnancy-safe sunscreen of at least SPF 30 should be applied every day. You should also wear hats and protective clothing when out in the sun. Discuss any concerns with your healthcare provider, but know that in many cases, melasma fades on its own after pregnancy.

For more info:

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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