All you need to know about melasma: causes and treatment

Melasma is one of the most stubborn pigmentations to treat and can be particularly vexing to manage due to Singapore’s year round sunny weather. Fret not, though, because we’re here to help you understand the condition better and the available skin pigmentation treatments. 

What is melasma?

Melasma is a skin condition that manifests as the development of irregular, flat, and pigmented patches on the skin, typically on the face. These patches usually appear as varying shades of brown, gray, or tan and have well-defined borders. The condition is often symmetrical, meaning it affects both sides of the face in a similar pattern.

While melasma can affect people of all skin types, it is more prevalent among individuals with darker skin tones, especially those of Asian, African, Hispanic, or Middle Eastern descent.

Causes of melasma

The causes of melasma are multifaceted. These are the factors you need to consider.

Hormones

Hormonal fluctuations are a leading cause of melasma, particularly in women. Pregnancy, oral contraceptives, and hormone replacement therapy can all induce these changes through the overproduction of melanin, the pigment that gives skin its colour. This condition is so common during pregnancy that it’s often referred to as the “mask of pregnancy.”

Sun exposure

Sun exposure is another major trigger of melasma. Ultraviolet (UV) light from the sun can intensify the melanocytes that produce melanin. This is why individuals living in regions with intense sun exposure or those who spend a lot of time outdoors are more susceptible to melasma. It is also why melasma often worsens during the summer months when the sun is most intense.

Genetics

Genetic predisposition also plays a significant role in the emergence of this condition. Those with a family history of melasma are more likely to develop it.

Medications and skincare products

Some drugs, such as anti-seizure medications and hormonal therapies, are known to stimulate melanin production and cause melasma. Additionally, skincare products that irritate the skin may cause an increase in melanin production, leading to melasma.

Diagnosing melasma

Melasma is usually diagnosed by a physical examination conducted by a healthcare provider or a skincare professional. While the characteristic appearance of melasma – dark, discoloured patches often symmetrically arranged on the face – is often sufficient for a diagnosis, a Wood’s lamp or dermatoscope may be used

During the examination, your care provider may also ask questions about your medical history, including any hormone treatments, family history of melasma, sun exposure habits, and use of cosmetic or skincare products. This helps to identify any possible contributing factors to the condition.

Treatment options for melasma

Managing melasma can be challenging due to its recurrent nature. However, various therapies have been developed to deal with this skin condition. 

Topical treatment

Among the first-line treatments for melasma are topical applications. These consist of creams, gels and lotions designed to lighten the skin. They contain active ingredients such as hydroquinone, which work by hindering the enzyme tyrosinase, thereby reducing melanin production. 

Tretinoin (Aklief), azelaic acid, and kojic acid are also agents which aid in decreasing melanin levels and promoting skin cell turnover. In cases where inflammation is a contributing factor, topical corticosteroids may be used. While some of these treatments are available over the counter, others with higher concentrations require a prescription.

Chemical peels and microdermabrasion

Facial procedures like chemical peels and microdermabrasion can be effective in treating melasma. Chemical peels exfoliate the skin’s outer layers, encouraging the growth of fresh, healthier skin.  Microdermabrasion uses minute crystals to exfoliate the skin surface, improving melasma’s appearance. 

These procedures can occasionally cause skin irritation, so professional supervision would be necessary to prevent skin damage.

Read more about the common pitfalls of melasma treatment. 

Laser treatment

Laser treatments have become an increasingly utilised option for severe or stubborn cases of melasma. These treatments work by deploying concentrated beams of light to target and destroy melanocytes, the cells that produce melanin. 

Several types of lasers can be used for this, including fractional lasers and Q-switched lasers. Fractional lasers create microscopic zones of thermal damage which help to remove the pigment and stimulate the body’s healing response, leading to rejuvenated skin. On the other hand, Q-switched lasers emit high energy light pulses which specifically target and break down the excess pigment.

Light therapy

The process of IPL involves the utilisation of light energy to precisely eliminate pigmented or impaired skin cells. Diverse light wavelengths are applied on the skin, leading to the heating and subsequent breakdown of skin cells. The body subsequently removes the compromised tissue naturally.

Prevention and maintenance

One of the first things you can do to prevent the formation of melasma on your face is to limit your sun exposure. 

Use a broad-spectrum sunscreen with an SPF of at least 30 every day, even when it’s cloudy. Make sure to reapply sunscreen every two hours when you’re outdoors, and more often if you’re swimming or sweating. Wearing wide-brimmed hats, sunglasses, and clothing that covers your skin can also provide extra protection.

Additionally, managing potential triggers is key. If you’re pregnant or considering hormonal therapies, be aware that these can stimulate melanin production, causing or worsening melasma. Discuss potential risks and alternatives with your healthcare provider. If certain skincare products cause irritation or redness, discontinue use as this can also exacerbate melasma.

For maintenance after treatment, continue your sun protection habits. Even small amounts of sun exposure can trigger the return of melasma. Your skincare professional may also recommend maintenance therapy with topical creams such as hydroquinone or other skin lightening agents to prevent recurrence.

Professional skin pigmentation treatment in Singapore

Don’t live with unwanted spots on your face. Get rid of your melasma with our experienced, well-trained professionals who work tirelessly to solve your melasma problems. At SkinLab, Singapore’s largest medical spa chain, our highly trained therapists can help you get the smooth, clean complexion you dream of.

Make an appointment now.