What is melasma?
Melasma is a skin disorder characterized by irregular patches that range from light brownish to darker brown tones. It does not cause any itching, stinging or is linked to the origin of any cancer. It is a benign pathology that does not cause any harm, but it can affect confidence and even require psychological help in some cases.
It is detected more often in women than in men and can occur by a wide range of factors, such as genetic predisposition, ultraviolet radiation, pregnancy, drug use and hormonal factors, which may be due to a thyroid problem or the use of oral contraceptives.
There are three types of melasma:
- Epidermal melasma, implies that the hyperpigmentation is found in the most superficial layer of the skin.
- Dermal melasma, where the pigmentation reaches a deeper layer of the skin, called the dermis.
- Mixed melasma, it is a combination of the two previous ones, and it affects both the epidermis and the dermis. This form of melasma is the most common.
Where is it usually located?
It manifests mainly on the face in a symmetrical way around the forehead, the jaw area and can even spread to the neck.
The cause of this disorder is still not completely known, but it has been observed that people with darker skin tend to suffer from it more than people with light skin.
What are the main factors causing melasma?
Genetic Predisposition
Most people with melasma have a family history, since the genes that synthesize the hormones involved in the formation of melasma are passed down from generation to generation.
Sunbathing
Melasma usually develops mainly in summer, because the well-known UVA rays increase the activity of the cells in charge of controlling the production of the pigment that gives our skin its colour. These cells are called melanocytes.
Pregnancy
The cases in which melasma is observed in pregnant women are called "chloasma gravidarum" or "gestational mask". Pregnancy comes with very strong hormonal changes, including increased production of oestrogen and progesterone from the eighth week. Although melasma is observed in a large percentage of pregnant women (50 to 70%) from the second half of pregnancy (which coincides with the increase in both hormones), it usually disappears on its own after delivery, although on some occasions it can persist and will require medical treatment.
Contraceptives
As discussed, hormonal changes can cause melasma, especially changes in oestrogen and progesterone levels.
Prevention
To prevent melasma it is important to stop the effects that trigger it. One of the main triggers for this pathology is exposure to UVA rays, so it is recommended to use sun creams with a high protection factor. Use a hat or a cap.
How is melasma treated?
There are several melasma treatments such as depigmentation, laser, pulsed light or chemical exfoliants.
The use of depigmenting agents that act by decreasing the activity of melanocytes. There are several types, such as hydroquinone, which has proven to be the most effective, tretinoin, azelaic acid, retinols, adapalene, or ascorbic acid.
Laser treatments generate a decrease in melanocytes and, therefore, in the pigment they generate. Pulsed light can also be used for those whose melasma is not just superficial, but has depth.
Chemical exfoliants are another option for the treatment of melasma, but their use is exclusive for people with pale skin, since in those with darker skin it can produce a "rebound effect" and even increase spots after treatment due to skin irritation.
When in doubt, and because there are spots that could be cancerous make an appointment with your doctor to get a check-up.
