What is melasma?

Melasma is a common skin condition that affects both men and women of all ages, can last for years or decades, and can impact self-image, self-confidence and self-esteem. It is common in pregnant women and has been called “the mask of pregnancy”.  Melasma also affects dark – skinned people who live in areas of the country where there is intense exposure to UV radiation from the sun, like Tucson!

What are the symptoms of melasma?

The typical presentation of melasma is the presence of well – defined, symmetrical, tan, brown and black hyperpigmented patches on sun exposed areas of the facial skin. The patches tend to appear on the cheeks, nose, forehead, chin, and upper lip. However, patches can appear on any area that is frequently exposed to the sun including the forearms and neck. Melasma usually improves in the winter when the sun is less intense and worsens in the summer.

The only symptom of melasma is discoloration however not all discoloration is melasma. Dr. Farhang is able to identity and diagnose melasma based on a physical exam with special light devices.

What causes Melasma?

The cause of melasma is still unclear, but intense sun exposure and fluctuations in hormone levels activate the skin cells, called melanocytes, to produce excess melanin, the substance that gives skin its color. People of color are more prone to melasma because they have more active melanocytes than people with light skin. Melasma runs in families and develops over time.

Common melasma triggers include:

• Ultraviolet (UV) light from the sun is a huge trigger and can aggravate underlying causes like hormonal changes. Even a short exposure to the sun’s light and heat can worsen existing melasma and cause it to return after treatment.
• Hormone fluctuations common during pregnancy, oral contraceptives or hormone replacement therapy are known to cause melasma in women. In men, the imbalance between estrogen and testosterone is believed to play a role.
• Recent research suggests that certain drugs and topical products may make the skin more sensitive to the sun and contribute to the development of melasma.

How is melasma diagnosed?

Because of its characteristic appearance, melasma is often diagnosed visually and with the use of a Wood’s Lamp which can distinguish excess melanin in the top skin layer from discoloration in the dermis. However, because melasma is often caused by an underlying condition board-certified cosmetic dermatologist Dr. Sheila Farhang will review your medical history and determine the triggers that underlie your condition and make adjustments.

How is melasma treated?

First and foremost, treatment is geared at preventing aggravation of the condition by the sun which requires the diligent use of sunscreens and other sun protective measures. Sunscreens block the sun’s rays as well as the light and heat. Sunscreen is essential. The best choice is a physical blocking agent such as zinc and titanium dioxide. When spending time outdoors, the patient should wear a hat and long sleeves.

Topical medications to lighten the patches include retinols applied to speed up cell turnover can facilitate faster clearing. The addition of a skin lightening cream that contains hydroquinone, a bleaching agent, will be recommended. However, it is important for Dr. Farhang to supervise its use to avoid areas of hypopigmentation. Kojic acid or azelaic acid are also topical skin lighteners that may be recommended. Importantly, Dr. Farhang is one of a few dermatologists in the United States who has been trained in the use of a special oral medication for melasma called tranexamic acid.

Additional treatments include chemical peels and laser skin resurfacing. Combination treatments are the most effective. Dr. Farhang will personalize a treatment plan to successfully address your specific needs, help the skin heal, and prevent future damage.

Melasma is frustrating and can be chronic. It is difficult to treat and tends to reoccur if not properly managed. Dr. Farhang is an expert in melasma and hyperpigmentation and has published articles in respected medical journals on the subject.

At Avant Dermatology & Aesthetics, Dr. Farhang will work with you to obtain a good outcome including restoring your appearance and confidence. Contact our dermatology office today to schedule a consultation and learn about all your treatment options. People in the Tucson Arizona area are fortunate to have an expert in melasma and hyperpigmentation in sunny Tucson.