What is Melasma? Treatment Options, Types, Causes and More

What is Melasma? it is a common skin condition that causes discolored and dark patches on your skin. Owing to its high prevalence during pregnancy, nearly 15-50% [1], melasma is also often known as the ‘mask of pregnancy. Another lesser-known word for melasma is chloasma. Melasma in men is not as common as in women. According to research, the condition affects women 9X more than men. The most effective melasma treatment combines sun protection with medications.

Melasma usually darkens and lightens over a period of time. Often, the condition may get worse during summer and better during winter. Melasma looks like gray, blue, light or dark brown freckles or flat patches. Areas that are commonly affected by this condition are the face and forearms. It can appear on your forehead, upper lips, or cheeks. Despite being harmless, having visible melasma on your face can make you feel self-conscious or anxious in public spaces.

Read on to understand the types, symptoms, and cause of melasma as well as melasma treatment options.

Types of melasma 

The type of melasma you have depends on the depth of the pigmentation. Usually, the black light of a Wood lamp can help determine this. Here are the common types of melasma.

Epidermal 

This type of melasma is usually brown and may also have a well-defined border. Its appearance is generally obvious under a black light. Epidermal melasma usually responds well to treatment.

Dermal 

In case of dermal melasma, the discolored patches on your skin will generally have a bluish or light brown color. It also has blurry borders. Generally, dermal melasma doesn’t respond well to prescribed treatment.

Mixed 

This is the most common form of melasma and has both, brownish and bluish patches. When seen under a black light, this type appears to have a mixed pattern. Mixed melasma responds to the treatment prescribed to some extent.

Symptoms of melasma 

Hyperpigmentation is a primary sign of melasma. If you have it, your skin loses its color or its tone becomes uneven. This type of melasma may typically be darker than your skin tone and is usually flat. Patches of melasma are generally pain-free but may make your feel uncomfortable.

Usually, melasma on face covers the following areas.  

• Nose, cheeks, upper lip, and forehead: Also known as centrofacial 
• Cheeks: Also known as lateral cheek pattern, where the patches are visible on both cheeks 
• Jawline: Also known as mandibular 
• Cheek and nose: Known as malar

In rare cases, melasma can also appear on your neck, upper arms and shoulders. Melasma on upper arms and shoulder is also known as brachial melasma. Melasma on neck generally appears in people over the age of 50 [2].

The best way to know if you have melasma is to consult a doctor as soon as you see the signs. Your dermatologist can help you get an accurate diagnosis and form a melasma treatment plan. If needed, you doctor may also advise you to get a biopsy to help diagnose the condition.

Causes and triggers of melasma 

The exact cause of melasma is not yet known. But it is suspected that melasma may be the result of a malfunction of melanocytes. These are color-making cells of your body. Their malfunction can produce excess color in certain spots. Common triggers or causes of melasma are exposure to radiation in the form of visible light, UV rays, or infrared light.

Other causes and triggers of melasma include the following: 

• Anti-seizure medicines 
• Birth control pills 
• Hypothyroidism 
• Genetic factors 
• Pregnancy 
• Hormonal changes 
• Skincare products 
• Tanning beds 
• Certain soaps 
• Certain cosmetic products

Melasma treatment options 

The best treatment for melasma on face, neck, upper arms, or anywhere else is to make sure that the condition does not worsen. In order to do so, avoid all the possible triggers. If you are in the sun for a long period, use a sunscreen that contains iron oxide and has an SPF of 30-50. Make sure to apply it after every two hours and wear a hat that has a wide brim.

Your doctor may also prescribe creams or a topical steroid that can help lighten the areas affected by melasma. Doctors may also advise you to get dermabrasion, chemical peels, or microdermabrasion. These melasma treatment options work by removing the top layers of your skin to lighten the patches. In rare cases, there is no option to lighten the patches.

Keep in mind that even after successful treatment, melasma can reappear. In order to reduce the chances of reappearance, go for regular visits and follow the skin practices prescribed by your doctor. You can also try ayurvedic skin care home remedies but be sure to talk to the doctor before taking any steps.

Melasma can mimic other forms of hyperpigmentation and skin conditions including cancer. Because of these characteristics of melasma, it is important to get an accurate diagnosis and treatment. Book a teleconsultation or in-clinic appointment with top dermatologists on Bajaj Finserv Health as soon as notice any symptoms, be it of melasma, hives on skin, or any other condition. This way, you can get treated at the right time and protect your skin.