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Melasma
What Is melasma?

Melasma also known as chloasma faciei, is a common skin problem. Melasma presents as brown or grey-brown patches on the face, especially on the cheeks, bridge of the nose, forehead, chin, and above the lips. This area is classically known as the butterfly area of the face. It sometimes can be seen on other parts of the body also like the forearms and the neck.

What are the causes of melasma?

The exact cause of melasma is not yet known. It can be due to Sun Exposure: It is seen only in sun exposed areas of skin. Hormonal: Pregnant women can have melasma known as mask of pregnancy. Birth control pills and hormone replacement medicines can also cause it. Heredity: It is commonly seen among first degree female relatives. Stress, nutritional deficiencies, anxiety and depression have also been found to be associated with melasma.

Things to Know

It is more commonly seen in females of reproductive age group, related to intake of oral contraceptives, pregnancy & lactation. It is also very common in patients of menopausal age group.
This condition is more commonly seen in females.
Unprotected sun exposure, stress, nutritional deficiencies, intake of some photosensitizing medicines can aggravate melasma.
Melasma can be seen in some families. Also, it is more commonly seen in some ethnic groups as compared to others.
Melasma is a resistant and stubborn condition. Yes, in most of the cases medicines do work but only for epidermal melasma. Common medicines used to treat melasma are arbutin, glycolic acid, kojic acid, hydroquinone, azelaic acid, licorice, tretinoin etc. In dermal melasma, medicines alone don't work so in such cases, we can do some treatments like chemical peels which include glycolic acid peels, yellow peel (retinol peel), phytic acid peel, mixed peels etc. Q Switched ND-yag laser(fractional and continuous mode), laser photo facial, and Satya’s unique 5D facial are also helpful in treating melasma.
The most important treatment aspect is regular use of sunscreen and other sun protective measures. Oral Glutathione, Tranexemic acid, iron & multi-vitamin supplements also are given as per your dermatologist's discretion. Topical depigmenting agents, such as hydroquinone, arbutin, mequinol, tretinoin, azelaic acid, kojic acid, liqorice, etc help in lightening the melasma patches. Procedural treatments such as chemical peels, microdermabrasion, 5D facial, and laser photo facial, PRP & hydra facial are also useful in lightening melasma patches.
Yes, these treatments are safe but should always be done under the supervision of a dermatologist. There can be chances of post inflammatory hyperpigmentation with these treatments, so one has to be very careful with these treatments. It should never be taken at beauty parlours or cosmetic chain clinics.
One must use sunscreen on a regular basis, if one does not use it regularly then melasma sometimes backfires and hyperpigmentation increases. Besides this the use of makeup and other cosmetic products should be avoided immediately after the procedure and one should follow the instructions of the dermatologist.
Melasma is a very notorious condition which has a tendency to come back again and again. Melasma associated with pregnancy and lactation usually does not come back, but in other cases, melasma has a tendency to come back. So, you should follow all the precautions and keep using the medicines as advised by the dermatologist.
According to Dr. Ruchi Agarwal, MD (renowned dermatologist), melasma is a very stubborn condition and some times it is frustrating because it is right in the middle of the face, so many a times people who have melasma may get depressed because of this and cut down on their socialization. The stress of this disease adds on to the problems which may increase the problem itself. So, a patient should maintain a positive attitude towards the treatments. Usually, we need combination of different treatments to treat melasma. Complete faith of the patient in the doctor and treatment is very important in the final outcome.
A prior consultation is required with the dermatologist to understand the need of the treatment. Medicines work hand in hand with the procedural treatments. Selection of the right treatment according to your needs is very much necessary. Knowing the downtime of the individual treatment and its outcome is equally important. After a thorough consultation , patient can opt for the treatment and can get it done after taking a prior appointment as per his/her availability.

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