WHAT IS MELASMA? By: Gloria Vergara-Octaviano

Have you ever noticed dark brown patches on your cheeks, forehead or chin recently? Well.it could probably be melasma. So, what exactly is Melasma. Melasma sometimes called chloasma or “mask pregnancy” is a skin pigmentation more commonly seen in Asians and Hispanics. The exact cause of melasma is unknown but it could be trigerred by several factors and the most common is sun exposure. Women who are pregnant can also develop melasma that fades after pregnancy thus it is also called “mask of pregnancy”.Other risk factors are oral contraceptives (Progesterone), Hormone Replacement Therapy (HRT),cosmetics or products that makes the skin sensitive to light and hypothyroidism (low level of thyroid hormone). Uncontrolled sunlight exposure is considered the leading cause of melasma, especially in individuals with family history of melasma. Clinical studies have shown that individuals usually develop melasma in the summer months, when the sun is most intense. In the winter, the hyperpigmentation tends to be less noticeable. Melasma presents as symmetrically distributed hyperpigmented macules in areas that receive maximum sun exposure, including the cheeks, the upper lip, the chin, and the forehead, however, melasma can also be seen in other sun-exposed areas of the body. Melasma is more common in women than in men; It generally starts between the age of 20 and 40 years, but it can begin in childhood. Melasma is more common in people that tan well or have naturally brown skin (Asians and Hispanics) compared with those who have fair skin (Caucasians). Melasma is one of the skin pigmentation I find hard to treat especially if it has been present for a longer period and since it responds to treatment gradually there’s always the tendency for patients to resort to other over the counter topical creams that might cause hypersensitivity resulting to more skin damage. Each of us has different skin types so what is effective for your friend might not work for you so it is always better to seek help from experts.  Melasma can improve with microdermabrasion, Intense Pulsed Light (IPL) or laser treatment, a machine that destroys the melanin pigment by means of heat and light. Topical depigmenting agent can also help like Hydroquinone, Azelaic acid and Vit. C. I find the combination of Hydroquinone, Retinoic Acid and Hydrocortisone (Kligman’s formula) more effective than other creams. Oral medications that are currently under investigation includes Tranexamic acid (also used to stop bleeding) and Glutathione but both are not recommended at this time. Melasma can improve in time but there are no overnight treatments. There is no hard and fast rule in treating melasma it is always a case to case basis. Ask your skin practitioner/dermatologist about your options.