Melasma

Melasma is a long-term facial pigmentation condition that often requires ongoing management.

Melasma is not known to cause serious physical health issues,  but it can have a significant effect on emotional well-being and quality of life. The condition can persist for many years or may be permanent in some cases.

Who gets melasma?

Melasma tends to appear in young adulthood (20 to 40 years of age). It’s more common in people with darker skin types, and people with a family history  of melasma.

Melasma affects women five to ten times more commonly than men. It is more common during pregnancy and in response to hormonal treatments such as oral contraceptives or hormone replacement therapy.

What causes melasma?

Melasma occurs when melanocytes, the pigment-producing cells in the skin, produce excessive pigment. Pigment may leak into lower levels of the skin, making it more difficult for many topical treatments to work effectively. In many cases, there appears to be excessive growth of skin blood vessels.

Triggers for worsening of symptoms include:

• Sun and other forms of light: Ultraviolet (invisible) and visible wavelengths of light (especially blue and violet colours).
• Relatively low levels of light – even indoors in some cases – can make melasma pigmentation worse.
• Hormones due to pregnancy, oral contraceptives and hormone replacement therapy.
• Skin inflammation and irritants, including scented cosmetics and soaps.
• Medications that make the skin more sensitive to sunlight can worsen melasma.
• Heat can make melasma worse by stimulating melanocytes and dilating blood vessels.

What does melasma look like?

Melasma appears as patchy brown discolouration on the skin, often appearing on the forehead, cheekbones and along the jawline. Patches are light to dark brown in colour, sometimes with grey or pink tones. The borders are irregular and may be well or poorly defined, depending on the depth of pigmentation. The distribution is usually symmetrical, i.e. the same on both sides of the face.