How to treat Melasma

What is Melasma?

Melasma is a common acquired skin disorder that presents as blotchy brown facial pigmentation typically involving the cheeks, top of lips, forehead, and bridge of the nose. Melasma is more common in women than in men and in people who tan easily or have naturally brown skin. It is less common in people with fair skin or black skin.

What causes Melasma?

The cause is complex, and it is a mixture of genetic predisposition, sun exposure, hormones (pregnancy, use of oral contraceptive pill, hormone replacement therapy), certain medications, and highly scented products which cause a phototoxic reaction to trigger melasma.

What are the types of Melasma and why is this important?

Melasma is classified as epidermal, dermal, and mixed depending on the level of increased pigment (melanin) deposit in the skin. Epidermal melasma responds well to treatment and it is superficial. Dermal pigmentation responds poorly to treatment. Most clients will have a mixed type of dermal and epidermal pigmentation.

What is the treatment for Melasma?

At the Marr clinic, we have a multi-targeted approach to deliver the best results, starting with a skin consultation with one of our experienced practitioners. General measures include lifelong sun protection with a physical sunscreen, a broad-brimmed hat and SunSmart behaviour. We also do a medical and medication review to identify any potentially reversible triggers. Topical skin care includes a combination of prescription hydroquinone (a de-pigmentation agent), retinoid (a type of Vitamin A) Vitamin C and an exfoliating agent.

Oral tranexamic acid, a medication traditionally used to stop heavy bleeding can be used to prevent the formation of pigmentation in response to UV exposure. Clear and Brilliant laser is a laser that treats a fraction of your skin with micro-columns of energy into the affected area. There are 2 different wavelengths available to target pigmentation or melasma at different depths of the skin. Another in-clinic treatment that helps is a chemical peel with alpha or beta hydroxy acids. Chemical peels can accelerate the turnover of the pigment accumulation in epidermal pigmentation which removes the pigmentation quicker. However, there are no quick fixes for this condition especially if it's been present for a long time. Even in those who have had a good result from treatment, relapses can happen with exposure to the sun and hence the need for lifelong sun protection and continuation of prescribed skin care.

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