What is Melasma?
Melasma is a medical condition involving discoloration of the skin, often on the face and neck. Often referred to as chloasma or the “mask of pregnancy” when it occurs in pregnant women, melasma is characterized by irregular patches of skin that are darker than the surrounding skin (hyperpigmentation). Melasma is not associated with any other physical symptoms.
Although the exact cause of melasma is not known, the condition is assumed to be hormone-related and occurs most often in women, particularly those who are pregnant or receiving hormone therapy. Melasma appears to be hereditary as people with a family history of melasma are more likely to develop the condition. You are also more likely to develop melasma if you have dark, brownish skin. Melasma is strongly associated with sun exposure and daily use of sunscreen seems to prevent the condition from developing. There may also be a link between certain types of cosmetics and melasma.
Can It Be Treated?
When it occurs during pregnancy or in response to hormone therapy, melasma often fades in the months following childbirth or cessation of hormone replacement, although it may return with subsequent pregnancies or use of these medications. Sometimes, though, melasma does not fade on its own.
For years, individuals affected by melasma have sought effective, permanent treatment for their condition with little success. Now, however, dermatologists are seeing excellent results with new, cutting-edge treatments like “fractional” laser treatment. This type of laser treatment involves the use of a specialized device that targets the cells below the surface of the skin that are responsible for causing the discoloration while leaving the surrounding skin cells unharmed.
Other popular and effective treatments for melasma include laser skin resurfacing, chemical peels and topical skin lighteners.
What Are the Benefits of Treatment?
Effective treatment of your melasma can offer improved self-image, improved social functioning and an enhanced overall quality of life. Melasma can have a severe psychological and emotional impact on individuals who are affected. Those who suffer from melasma are very likely to experience low self-esteem, diminished confidence in social situations and the feeling that they are treated differently by others as a result of their appearance. Treating the underlying cosmetic condition can help to eliminate these negative feelings.
Treatments are available that offer relatively quick results with only minimal downtime. In most cases, particularly if you choose to begin therapy with a topical cream, you will be able to return to your normal activities immediately and will not need to miss work or social engagements as a result of your treatment. If you choose a light chemical peel, you can generally return home or to work right away. If a deep chemical peel or intensive laser resurfacing procedure is performed, you can expect a longer recovery period, but usually not more than a few weeks.
What Are the Risks?
The level of risk associated with your melasma treatment will vary based on the type of treatment you choose. The risks associated with laser skin resurfacing include infection, scarring and additional hyperpigmentation (or, alternately, pigment loss) in the treated areas. It is extremely important to follow your doctor’s aftercare instructions in order to reduce the risks associated with laser treatment.
A chemical peel presents similar risks as well as the possibility of an allergic reaction to the chemical used. The deeper the peel (light chemical peels are often used to treat mild cases of melasma), the greater the risks associated with the procedure.
Although associated with fewer risks, topical creams can also cause adverse effects. You should discuss the risks and expected benefits of any potential topical treatment before you begin using it.
Fractional laser treatment is associated with fewer risks than peels or skin resurfacing, but can cause swelling or redness. In most cases, side effects will only last a few days. There is also the slight risk of infection or scarring.
Because melasma is a chronic condition, there is always a risk of dark patches reappearing on your skin after treatment. Your doctor will probably recommend that you take extreme care with regard to sun exposure—wearing a strong sunblock at all times and protective clothing as necessary to ensure that the condition does not return or worsen.
The Bottom Line
Although the treatment options for melasma are not without risk, leaving your condition untreated can have damaging psychological and emotional effects. If you are unhappy with the way you look and believe that your quality of life is being negatively impacted by the appearance of your skin, talk to your doctor or visit your local medical spa to see what types of treatment are available to you.
The information in the article is not intended to substitute for the medical expertise and advice of your health care provider. We encourage you to discuss any decisions about treatment or care with an appropriate health care provider.
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