Treating Melasma

You’ve probably known pregnant women who developed brown to grey-brown patches on the face and other areas of the body. You may not have known the condition has a name, melasma.

Melasma affects areas of the body that get lots of sun and can be triggered by hormonal changes. Since there isn’t a time with as violent hormonal changes as during pregnancy, melasma often accompanies it. For that reason, melasma has another name, “the mask of pregnancy.”

Dr. Kronberg treats melasma in her patients.

Who gets melasma?

Melasma is mostly an issue for women, as only 10% of those who get the condition are men. It tends to affect people with darker skin tones and there seems to be a genetic element. If you’ve had a blood relative with melasma, you’re far more likely to get it as well.

What causes melasma?

As with other skin conditions such as rosacea and even eczema, there isn’t a direct cause/effect relationship with melasma. Most dermatologists and researchers believe the condition is likely the result of the melanocytes — the skin cells responsible for pigment — overproducing color. That’s why it is believed that people who already have more pigment in their skin are more prone to melasma because their melanocytes are more active than people with fair skin.

Certain triggers seem to initiate the development of melasma:

• Sun exposure — The ultraviolet light from the sun triggers the melanocytes in the exposed skin to produce pigment as a safety mechanism. This is why human skin tans. Once a person with melasma is exposed to some sun, an area that has faded will often become darker again. Because of this, more cases of melasma occur during the summer.
• Hormonal changes — Pregnant women often get melasma due to the extreme changes in their hormones. Two other hormone modifiers, birth control pills and hormone replacement medicines, can trigger melasma.
• Cosmetics — Certain cosmetics can worsen melasma if they irritate the skin.

Not harmful, only irritating

Melasma doesn’t threaten physical harm; its effects are purely cosmetic. But melasma can be embarrassing when it fully breaks out in brown or grey-brown patches on the surface of the skin.

These are the common areas it shows itself. As you can see, all of these areas get serious sun exposure:

• Cheeks
• Forehead
• Above the upper lipBridge of the nose
• Chin
• Forearms and neck (less common)

How we treat melasma

Melasma will often fade away on its own once the patient better protects herself from sun exposure. In the same way, melasma triggered by pregnancy passes when the hormones calm down.

Sometimes, however, the condition persists. In these cases, Dr. Kronberg may use one or more of these treatments:

• Hydroquinone — We use prescription-strength hydroquinone usually as a first option. When applied to the darkened areas, it lightens the skin.
• Tretinoin and corticosteroids — Beyond hydroquinone, these are the next two steps in enhance skin lightening. Sometimes we will use a cream with all three medicines (hydroquinone, tretinoin, and corticosteroid).
• Other topical medicines — Azelaic acid and kojic acid also lighten the skin
• Procedures — If topical applications don’t seem to be generating the results you seek, we can opt for chemical peels (usually glycolic peels), microdermabrasion, or dermabrasion.

Just because we get your melasma to fade away doesn’t mean it won’t come back. It can be stubborn to fully eliminate, so sticking with your treatment plan from Dr. Kronberg is important.

If you think you’re showing “the mask of pregnancy” call Dr. Kronberg at 713-771-8941 and let’s take a look.