Melasma is a type of dyspigmentation which is often related to hormonal fluctuations, pregnancy or hormonal medication in women. The direct cause is unknown, though there are strong links to increased oestrogen and cortisone levels in the body, with 90% of melasma sufferers being women.
Melasma differs from solar pigmentation in that it occurs mostly during reproductive years in younger women and shows a distinct mask-like pattern which is usually mirrored on either side of the face. It often occurs on the cheeks/cheek bones and forehead, as well as the upper lip, and can form in conjunction with solar damage, making it difficult to detect or treat. Melasma is an inflammatory condition, which is why it is considered unwise to treat it with laser, IPL or any other heat emitting devices, as these can initially fade the discoloration, only for it to come back darker and more prevalent in later months. In rare occasions, melasma can present as superficial redness in the skin often mistaken for rosacea, which is why it is always wise to consult thoroughly with skin imaging machines before undertaking any clinical care for stubborn skin conditions.
Typical Melasma on the forehead and cheeks
Because it is a chronic condition, melasma cannot be reversed or removed, but can be reduced and well maintained with dedication and proper care. It can respond well to certain peels and sometimes skin needling, though strict homecare rules must be adhered to in order to protect the skin’s integrity and prevent further inflammation which may darken existing melasma, or trigger more to develop. Much like with solar pigment, hormonal pigmentation responds adversely to the sun, so SPF is non-negotiable, and clients must also take great care to avoid heat on the area, as this can also trigger melasma to worsen. This includes spas, saunas, hot yoga and hot showers running directly on the face. Vitamin A, B3 and C can assist in brightening and reducing melanocyte (pigment producing cells) activity, while certain topical products such as tranexamic acid can reduce the enzymatic triggers which lead to melanocyte activity, so melasma must be treated in several different ways for the best response, and this care may often differ between individuals.
For any concerns or clarification surrounding pigmented skin conditions, we offer thorough consultations with a skin scanner which will reveal any underlying issues within the dermis, so we can pin-point your exact skin requirements and advise on the best clinical options for your skin.