Definition

Melasma is a skin condition characterized by dark, irregular patches on the face.

It commonly affects women and people with darker skin tones.

Sun exposure and hormonal changes are often associated with the development of melasma.

What are the main signs and symptoms of Melasma?

Clinically diagnosed

Melasma is a common skin concern that is diagnosed clinically by dermatologists. Here are the details of how it is diagnosed:

• Medical History: Your dermatologist will start by taking a detailed medical history, including any symptoms or changes in pigmentation you have noticed.
• Physical Examination: The dermatologist will then examine your skin, paying close attention to the areas affected by hyperpigmentation.
• Wood's Lamp Examination: In some cases, a Wood's lamp, which emits ultraviolet light, may be used to evaluate the pigmentation more closely.
• Biopsy: In rare cases where the diagnosis is uncertain, a small skin biopsy may be performed. This involves taking a small sample of skin for further analysis under a microscope.

If you suspect you have melasma, I recommend seeking advice from a dermatologist who can provide you with a proper diagnosis and personalized treatment plan.

Treatment options

For medical treatments of Melasma, there are several options available:

• Topical creams: Hydroquinone, Tretinoin, and Corticosteroids are commonly prescribed to lighten the dark patches. They can be used alone or in combination.
• Chemical peels: Chemical peels containing alpha-hydroxy acids (AHAs) or beta-hydroxy acids (BHAs) can help to exfoliate the skin and lighten the pigmentation.
• Laser therapy: Procedures like laser resurfacing or intense pulsed light (IPL) can be used to target and reduce the dark pigmentation.
• Microneedling: This technique creates controlled micro-injuries in the skin, stimulating collagen production and improving melasma.
• Oral medications: In some cases, oral tranexamic acid or oral contraceptives may be prescribed to regulate hormonal changes and reduce melasma.

When it comes to skincare products for treating melasma, the following are commonly recommended:

• Broad-spectrum sunscreen: This is crucial for melasma management. Look for sunscreens with SPF 30 or higher, and ingredients like zinc oxide or titanium dioxide.
• Hydroquinone creams: Over-the-counter creams containing up to 2% hydroquinone can help fade melasma. Consult a dermatologist for stronger prescription options.
• Vitamin C serums: These serums can help brighten the skin and reduce pigmentation.
• Retinol or retinoid creams: These products work to accelerate cell turnover and improve the appearance of melasma.
• Exfoliating agents: Products containing AHAs or BHAs can aid in reducing melasma by gently exfoliating the skin.

Beauty procedures

For treating Melasma, there are several beauty procedures that can be effective:

• Laser Therapy: Specifically, Q-switched Nd:YAG laser can be used to lighten the pigmented areas of melasma by targeting the excess melanin in the skin.
• Chemical Peels: Chemical peels containing ingredients like glycolic acid, salicylic acid, or trichloroacetic acid can help in exfoliating the skin and reducing the appearance of melasma.
• Microdermabrasion: This procedure involves exfoliating the top layer of the skin using a special device. It can help in improving melasma by promoting skin renewal.
• Topical Treatments: Prescription creams containing ingredients such as hydroquinone, retinoids, corticosteroids, or azelaic acid can be applied to lighten the dark patches of melasma.
• Intense Pulsed Light (IPL) Therapy: IPL uses targeted light energy to break up the excess pigmentation in the skin, helping to fade melasma.

It is important to consult with a qualified dermatologist or skincare professional to determine the most suitable procedure for your specific case of melasma.

Diet

Diet can have an impact on melasma, although it is not the main cause of the condition. Melasma is primarily triggered by hormonal changes, sun exposure, and genetics.

However, certain dietary factors can worsen melasma or trigger flare-ups:

• Foods rich in estrogen: Estrogen-rich foods like soy, flaxseed, and certain dairy products may potentially exacerbate melasma by affecting hormone levels.
• Spicy foods: Spicy foods can cause increased blood circulation and make the skin more prone to pigmentation issues like melasma.
• High glycemic index foods: Consuming foods with a high glycemic index, such as refined carbohydrates and sugary snacks, can lead to inflammation and hormonal imbalances, potentially influencing melasma.
• Alcohol and caffeine: Excessive alcohol consumption and high caffeine intake can disrupt hormone levels and may trigger melasma.

While modifying your diet alone may not entirely prevent or cure melasma, making healthier dietary choices can support overall skin health and potentially help in managing melasma symptoms.

Exercise

Exercise can have both positive and negative effects on melasma. It's important to note that melasma is a skin condition characterized by dark patches or hyperpigmentation on the face, typically triggered by hormonal factors or sun exposure. While exercise itself doesn't directly cause or cure melasma, it can affect the condition in the following ways:

• Increased blood circulation: Exercise promotes blood flow throughout the body, including the skin. Improved circulation can potentially help deliver more oxygen and nutrients to the skin, supporting its overall health and potentially improving the appearance of melasma.
• Temperature and sweat: Intense exercise, especially in hot and humid environments, can increase body temperature and stimulate perspiration. Excessive sweating and heat can potentially aggravate melasma and lead to a temporary darkening of the affected areas.
• Sun exposure: Outdoor exercise can expose the skin to harmful UV rays, which is a known trigger for melasma. It is crucial to protect the skin during exercise by wearing a broad-spectrum sunscreen with a high SPF, seeking shade whenever possible, and wearing a wide-brimmed hat or using protective clothing.

It is recommended to consult with a dermatologist or skincare professional for personalized advice on managing melasma while incorporating exercise into your routine.

Oral supplements studied for Melasma

Several oral supplements have been studied for melasma, although it's important to note that results may vary from person to person. Here are a few supplements that have been researched:

• Polypodium leucotomos: This fern extract has shown promising results in reducing melasma when taken orally. Daily supplementation with 240-480 mg of Polypodium leucotomos extract has been suggested.
• Pycnogenol: Derived from the French maritime pine bark, Pycnogenol has antioxidant and anti-inflammatory properties. Studies have shown some improvement in melasma when taking 75-100 mg of Pycnogenol daily.
• Glutathione: As an antioxidant, glutathione has been investigated for its potential to lighten pigmentation. Oral doses of 500-1000 mg per day have been used, but more research is needed to establish its effectiveness.
• Vitamin C: Known for its skin brightening properties, vitamin C may help in reducing melasma. Daily intake of 500-1000 mg of vitamin C has been suggested.

Before starting any oral supplement, it is crucial to consult with a healthcare professional to determine the appropriate dosage and to rule out any potential interactions with medications or underlying health conditions.

Frequently Asked Questions

References

1. Melasma, a photoaging disorder.
2. Melasma: Updates and perspectives.
3. Melasma.
4. Future therapies in melasma: What lies ahead?
5. Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies.
6. The pathogenesis of melasma and implications for treatment.
7. Melasma: a clinical and epidemiological review.
8. Efficacy and Safety of Tranexamic Acid in Melasma: A Meta-analysis and Systematic Review.
9. Melasma: The need for tailored photoprotection to improve clinical outcomes.
10. Dysbiosis of skin microbiome in melasma patients.
11. Optimizing Q-switched lasers for melasma and acquired dermal melanoses.
12. Post-Inflammatory Hyperpigmentation: A Review of Treatment Strategies.
13. The Low-Fluence Q-Switched Nd:YAG Laser Treatment for Melasma: A Systematic Review.
14. [Chemical peeling for treatment of Melasma, pigmentary disorders and hyperpigmentation : Indications, effectivity and risks].