Do you peer into the mirror and suddenly notice these pesky irregular-shaped brown patches that seem to appear out of nowhere? What you are looking at could be melasma, a type of hyperpigmentation, where the skin is darkened or discoloured. Melasma may be hard to treat but not impossible. I am here to help you understand more about this common skin condition, how to prevent melasma, and introduce a combination approach to effectively lighten your melasma. Let’s go!
Melasma is a common pigment disorder we see in Asian women and it usually presents in their 30s to 40s. It can affect the cheeks, forehead, nose bridge, and upper lip areas and it is notoriously hard to treat. Various factors, such as ultraviolet (UV) exposure, pregnancy, hormones and certain cosmetic products are known to worsen melasma, so it is important for us to identify and reduce these triggering factors during treatment.
Melanin is produced by melanocytes (pigment cells) and it is a dark brown pigment that is responsible for our skin colour. One of the most common causes is UV and visible light exposure, which are known to stimulate melanocytes, leading to overproduction of melanin and worsening of melasma.
A key preventative measure is therefore adequate sun protection. It can be achieved by proper application of sunscreen and also reducing the total amount of sun exposure. I would recommend using broad spectrum sunscreen with sun protection factor (SPF) of 30 and above. Sunscreen should be applied at least 2-3 times a day, every 2-3 hours, and in a thick layer to get the full SPF protection. About 3-4ml of product is needed for each application. Sunscreen should also be used even if you are at home as infrared light can also trigger melasma. However do bear in mind that even if sunscreen is properly applied, it will not block out all UV exposure. Hence one should still reduce the amount of time spent in the sun. Other sun protection measures include using umbrellas and wearing hats.
In terms of treatment, there are many different treatments for melasma but I find a combination approach to yield the best results as melasma is difficult to treat.
If you have melasma, the good news is good sun protection combined with medical treatment (lasers and chemical peels) and daily use of topical creams are typically sufficient to see a gradual improvement in 60-80% of the cases. In treating stubborn and refractory cases (especially dermal melasma), oral medication can be added with caution. I really want to encourage you to see a board certified doctor or dermatologist so that the most effective combination can be worked out for you.
Written by Dr. Wu Jiwei,
MBBS, PG Dip (Clinical Derm) (UK)
Disclaimer: The material contained in this is for informational purposes only and do not constitute medical advice. The content is not intended to be a substitute for doctor's advice, diagnosis, or treatment.