What is Melasma and How Can You Treat It?

Melasma is a well-known condition that occurs as dark discoloured patches on the skin. It is often confused with hyperpigmentation and primarily affects the facial regions of the body. While the good news is that melasma is medically harmless, its widespread occurrence may feel worrisome and psychologically impact the individuals affected by it. Hence, it is integral to understand melasma in detail, what is it, its effects as well as the treatment options available to mitigate its appearance. Follow along as we equip you with insights to address your concerns timely, promoting your skin health and overall confidence.

Keynotes:

• Melasma is a skin condition that manifests as dark patches on the skin
• It can be symmetrical and well defined, showing up on the face and neck.
• Treatment options include a combination of topical solutions, chemical peels and laser therapy.
• Broad spectrum SPF 50+ sunscreen is detrimental to your skin care routine for preventing the worsening of the condition.

Melasma is a chronic hyperpigmentation that manifests as flat, dark blotches of brown or greyish-black patches on the skin. It is a common condition and may claim space on your cheeks, forehead, bridge of the nose, as well as chin and neck. The patches are a result of an overproduction of the pigment melanin in our skin. While it is an integral element to give your face its natural colour, an imbalance in several factors may induce this condition.

Types of Melasma

Just as we begin to understand what is melasma, it is also integral to know the various types of it. The skin condition can be broadly categorised into three types:

• Epidermal Melasma

  Just as the name suggests, in the epidermal melasma, the pigment melanin is deposited on the outermost layer of the skin, the epidermis. It can manifest in well-defined patches resembling the colour dark brown under Wood’s lamp (a black light) examination. Moreover, this type responds well to melasma treatments such as chemical peels and topical serums.

• Dermal Melasma

  On the other hand, dermal melasma rests below the skin surface and deep within its dermal layer. This position makes the condition more challenging to treat and requires extensive treatment options such as laser therapy. This skin pigmentation may appear light brown or bluish-grey under examination.

• Mixed Melasma

  The most prevalent among the two is the mixed melasma type. It involves over-pigmentation in both the dermis and epidermis of the skin and will show up as both dark brown and bluish-grey spots. Mixed melasma requires a thorough, multi-faceted treatment approach.
  
  Melasma predominantly affects women, but men can experience it as well. The overall average onset is from 20 to the latest 40 years of age. Interestingly, melasma is often colloquially known as the ‘mask of pregnancy’, hinting that pigmentation grows prevalent on the mother’s face during gestation. However, apart from pregnant women, this skin concern may also develop in darker-skinned individuals as well as on account of several melasma causes which we will discuss below.

The subject of what exactly causes melasma is still undergoing research and currently cannot be pinpointed. That said, we do know that there is an array of factors that may play a significant role in this skin condition manifesting in an individual's body:

1. Hormonal Changes

   The hormonal changes, particularly oestrogen and progesterone, are cited during the emergence of melasma. These hormones are prevalent during pregnancy, the use of oral contraceptives, and hormone replacement therapy. They seem to trigger the overproduction of melanin, leading to the characteristic pigmentation of the disorder.

2. Sun Exposure

   Exposure to ultraviolet radiation from sunlight can be a significant aggravator of the condition. UV light or UV radiation may stimulate the melanocytes to produce more melanin for the body. Thus, leading to darker pigmentation of the spots and patches.

3. Genetics

   Unlike different types of hyperpigmentation, melasma is a condition where genetic predisposition plays a notable role. Precise genes that are responsible are not fully understood yet. Although research does suggest a family history of the condition may increase one's susceptibility to it.

4. Skin Irritation and Inflammation

   Reactions caused by harsh skincare, phototoxic drugs (sensitive to sunrays), UV light, etc., can stand to inflame the skin. Such skin irritation not only triggers melasma but may also worsen the existing pigmentation as a response to the irritants.

Following are the ways one can identify what is melasma in skin and how to differentiate it from other conditions:

1. Symmetrical Dark Patches

   Melasma often presents itself as symmetrical patches of pigmented skin across both sides of the face or body, be it the nose, chin, cheeks or upper lip. You may notice these darkened patches are often the ones most commonly exposed to the rays of the sun.

2. Gradual Onset

   Unlike post-inflammatory hyperpigmentation or allergic reactions, which may appear abruptly after the trauma to the skin, melasma usually develops gradually over time. Its early onset can show up as a slow and subtle darkening of the skin. This condition may worsen due to persistent exposure to the sun or other hormonal triggers.

3. Sharp Edges

   Patches typically tend to have a well-defined shape and colour that differentiates them from the surrounding skin. This clear outline can help a dermatologist diagnose and assess the depth of the skin condition under a Wood's lamp examination or through a skin biopsy with ease.

Based on the diagnosis and skin's needs, an advanced and personalised melasma treatment may be rolled out by your dermatologist. Here are a few methods that they may take to mitigate and manage the condition:

1. Topical Treatments for Melasma

   Topical medications are one of the first lines of therapy for hyperpigmentation as well as melasma. These treatments work by inhibiting the production of the pigment, reducing inflammation and boosting skin cell turnover. Some actives used in this treatment option may include Thiamidol, hydroquinone, niacinamide, kojic acid or azelaic acid.

2. Chemical Peels

   Often employed for treating epidermal melasma, chemical peels provide a targeted approach towards lightening the dark patches of pigment. The peels considered during this process are alpha hydroxy acid peels (glycolic acid), beta hydroxy acid peels (salicylic acid, lactic acid) or a combination of the two1. Since these are concentrated chemical solutions, peeling is done meticulously under a controlled environment by a registered professional.

3. Laser Treatments

   Laser treatments such as fractional laser, as well as low-fluence Q-switched lasers, are also used to target pigmentation caused by melasma. These treatments deliver potent beams of light towards affected areas and require multiple sessions. However, this course of treatment cannot be used in a silo and should be employed along with topical treatments for achieving optimal results.

4. Sunscreen and Sun Protection

   Regardless of which method is used to reduce the condition, sun protection is paramount to prevent it from exasperating further. Hence, a broad-spectrum sunscreen with SPF 50+ is wholly recommended in one's skincare routine to protect against UVA and UVB radiation from the sun.

Now, while the above treatments are integral, educating yourself on how to prevent melasma from worsening is equally important to ensure optimal skin health. Adopt these preventive measures to reduce the risk significantly:

1. Wear Sunscreen Daily

   Make sunblock a year-round, non-negotiable part of your skincare routine. No matter if it is a cloudy or a rainy day, never forget that the sun's radiation can penetrate through clouds as well. So remain consistent to prevent further UV-induced melanin production.

2. Avoid Sun Exposure During Peak Hours

   Limiting yourself from the sun when it is at its peak can be detrimental to preventing the after-effects of the harsh UV rays. Moreover, if you’re out from 10 AM to 4 PM in the day, make sure to seek shade whenever possible. Also, opt for protective clothing such as a wide-brimmed hat and sunglasses for additional protection.

3. Avoid Skin Irritation

   Harmful irritants can inflame the skin, aggravating melasma further. Hence, make sure you look for skincare products that are gentle and hypoallergenic, formulated especially for sensitive skin. You may also avoid products with harsh chemicals, scrubs and fragrances in your skincare.

If you are looking for science-backed products to support your skin’s health and target hyperpigmentation, then these Eucerin products are the ones for you:

Anti-Pigment Dual Serum

Eucerin dual action serum combines our potent ingredient Thiamidol with hyaluronic acid and Licochalcone A to target hyperpigmentation while hydrating and protecting the skin from inflammation. These actives further address fine lines and the reappearance of dark spots, leading to radiant skin.

Check out our product: Anti-Pigment Dual Serum

The Anti-Pigment Day Care SPF30

The immediate next step in your routine should be to care for your skin with a hydrating moisturiser. This antioxidant-rich day cream is lightweight and non-greasy, allowing for a no-fuss application throughout the day. It has SPF 30 as well as our star ingredient, Thiamidol, to help you battle sun-induced spots head-on.

Check out our product: Anti-Pigment Day Care SPF30

Sun Face Pigment Control Fluid SPF50+

Finally, complete your skincare routine with a high-performance SPF 50+ sunblock. This Eucerin sun protection is suitable for all skin types, especially sensitive skin, protecting you from both UVA and UVB rays. Moreover, the advanced spectral technology in the sunscreen not only combats oxidative stress but also blocks HEVIS light, leaving you with an even complexion.

Check out our product: Sun Face Pigment Control Fluid SPF50+

Through this blog, we understood the intricacies of melasma, what is it, the treatment methods and the preventive measures you can take to address the condition. Embracing an informed approach and using gentle products, such as the ones mentioned above, can help you mitigate the risk of exacerbating the condition further. However, it is essential to note that completely eradicating this skin disorder can be challenging. Thus, a certified dermatologist intervention is crucial in providing targeted treatments for optimal results and boosting skin health.

1. Is Melasma More Common in Pregnancy?

   Yes, melasma is highly common during pregnancy. This is because gestation results in an increase in oestrogen and progesterone levels in the mother's body. These hormones may end up stimulating melanocytes responsible for the production of pigment. However, these patches may also fade gradually as the hormone level stabilises after the birth of the child.

2. Is Melasma Hereditary?

   While not entirely responsible, genetics may play an important part in the development of melasma in an individual. While the exact mechanism still remains under research, a family history of the condition can make the individual more susceptible to it. However, it is also integral to understand that this predisposition coupled with other triggers may contribute to the onset as well.

3. What is the Best Sunscreen for Melasma?

   The ideal sunscreen to battle hyperpigmentation and melasma should be the one that targets both UVA and UVB rays of the sun. Hence, it is recommended you look for a broad-spectrum sunscreen with an SPF of 50 or above for adequate protection.

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