Melasma

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Patient Information Sheet: Melasma

What is Melasma?
Melasma is a common skin condition that causes dark, discolored patches on the face. It primarily affects women, especially during pregnancy or with hormonal changes.

Causes:

• Hormones: Fluctuations in estrogen and progesterone levels can trigger melasma. This often occurs during pregnancy (chloasma or “mask of pregnancy”) or with hormonal contraceptives.
• Sun Exposure: Ultraviolet (UV) light stimulates melanocytes (pigment-producing cells), worsening melasma.
• Genetics: Family history may increase susceptibility to melasma.

Symptoms:

• Dark, irregular patches typically on the cheeks, forehead, nose, upper lip, or chin.
• Patches may vary in size and shape, and can gradually darken with sun exposure.

Treatment:

1. Sun Protection: Use a tinted broad-spectrum sunscreen with SPF 50 daily, even on cloudy days or when indoors. Reapply every 2 hours and wear protective clothing and a wide-brimmed hat.
2. Topical Treatments:

• Hydroquinone: A skin-lightening agent that can fade melasma patches. Use as daily for a maximum of 12 weeks.
• Tretinoin: Can be used in combination with hydroquinone to enhance lightening effects. Use 2-3 nights a week for 1 month initially and increase as tolerated.
• Propaira Niaben HQ (Silymarin): Apply twice daily. Safe in pregnancy.

1. Procedures:

• Pico Laser Therapy: Targets melanin-producing cells to reduce pigmentation.

1. Cosmetic Camouflage: Makeup can help conceal melasma patches while undergoing treatment.

Management:

• Skincare Routine: Gentle cleansing and moisturising, careful with actives during treatment.
• Avoid Triggers: Limit sun exposure and wear protective clothing and hats.
• Hormonal Management: Discuss with your GP about managing hormonal fluctuations, especially during pregnancy.

Expectations:

• Treatment may improve melasma but complete clearance can be challenging.
• Results vary among individuals, and maintenance therapy may be needed to prevent recurrence.