Taking a closer look at melasma

Melasma is a very common hyperpigmentation condition of the skin that appears as blotchy brown patches. One of the most common triggers is prolonged exposure to the sun.

As we head towards sunnier skies in the months ahead, we thought we’d chat with Illawarra Medical Centre’s Dr Dhruva Ramachandran to find out a bit more about melasma and how the sun and other factors can impact on the condition.

Dr Ramachandran is a General Practitioner with special interests in pigmentary disorders of the skin, facial augmentation and laser medicine. He has more than 16 years of experience in the field of Dermatology and Cosmetic Medicine.

Can you tell us what melasma is exactly?
Melasma is a chronic pigmentary disorder that mainly occurs on the face. It’s basically blotchy, brownish patches that can be clearly seen on the skin and most commonly occurs on the forehead, cheeks and upper lip.

It is more common in women and those with darker skin types.

While melasma doesn’t have any specific symptoms or association with any underlying medical conditions, many people are uncomfortable with the way it makes their skin look.

What causes melasma?
The hyperpigmentation of melasma is generally a result of an overproduction of melanin – the pigment that gives our skin, hair and eyes their colour. This overproduction of melanin can be present in either the epidermis (the surface layer of skin), the dermis (the thick layer of living tissue that sits under the epidermis layer of skin), or both.

While there is no one direct cause of melasma, what we do know is that there are a number of different factors that can play a role.

These include:

  1. Gender – women are more prone to melasma than men.
  2. Skin Type – melasma is more common in those with skin of colour, including people with Asian, Hispanic, Middle Eastern and Mediterranean ancestry.
  3. Hormones – a change in hormones through pregnancy or from certain medications (including the oral contraceptive pill and hormone replacement therapy) can trigger the condition.
  4. Sun Exposure – prolonged exposure to the sun is one of the main contributors to hyperpigmentation of the skin.
  5. Skin Irritation – using skin care products that irritate the skin can worsen melasma if it is already present.

Melasma may fade on its own, particularly if it’s triggered by a short-term hormonal change such as pregnancy or taking oral contraception. However, if you have long-lasting and persistent melasma that causes you distress or embarrassment, then it might be worth a visit to your GP or dermatologist to look at ways to treat it.

We’re now heading into Spring and Summer where we’re more exposed to the sun’s rays. For those who do have melasma, what are some things can be done to help minimise its appearance during the sunnier seasons?
There are a number of different treatment options available, depending on the extent of the condition and the person’s specific skin needs.

In the first instance, the best thing to do would be to consult with your doctor or dermatologist to confirm that the darkened patches of skin are, in fact, melasma and not some other skin condition.

Because melasma can sometimes look like another skin condition, your doctor or dermatologist may need to undertake a small skin biopsy and remove a small piece of your skin. This is a very simple, quick and safe procedure that can be performed during a regular appointment.

Once melasma has been determined, there are a number of different treatment options that may be available to you to help treat the condition.

These include:

  1. Sun Protection
    Given the sun is one of the most common triggers for melasma, one of the best ways to treat the condition is to protect your skin against the sun, particularly throughout Spring and Summer. The best way to do this is to use a broad-spectrum sunscreen (SPF 30+ or more) at least twice a day and apply it 20 minutes before you go outside into the sun. I would also highly recommend wearing a broad brimmed hat for added protection.

2. Eliminating Medications
If your melasma is triggered by certain medications, such as the oral contraceptive or hormone replacement therapies, then you could speak to your doctor about using different medicines or stopping the medication altogether.

3. Removing Irritants
If it appears that your melasma has been caused by a skin care product irritating your skin, the easiest way to treat your melasma is to remove this product from your skin care regime.

4. Chemical Peel
Chemical peels may work to help treat melasma by having an intensive corrective effect on skin hyperpigmentation and regulating the overproduction of melanin to control the appearance of dark spots.

As results can vary for each patient, it’s important to consult with your doctor or dermatologist to determine if a chemical peel is a suitable treatment for you and your condition.

5. Microdermabrasion
Microdermabrasion is a minimally invasive skin treatment that can be used as a potential treatment option for melasma. It works to remove dead skin and stimulate collagen production to restore the skin’s elasticity and even out skin tone.

6. Laser
Laser is another potential treatment option for melasma. Before embarking on any type of laser treatment for your melasma, however, it is important to speak with your doctor or dermatologist to determine whether it is a suitable treatment option for you. In treating melasma, only certain lasers should be used and these should be used with extreme care, under the guidance of a dermatologist.

The number of laser treatments required will vary depending on the size, thickness and colour of the area to be treated.

Skin checks available at Illawarra Medical Centre
Dr Ramachandran holds skin cancer and dermatology checks at Illawarra Medical Centre every Tuesday morning.  He also works closely with our sister skin clinic – DermCosmesis – to assist patients with the best treatment solution for their specific skin needs.

To make a booking with Dr Rumachandran or any one of our GPs to discuss your skin concerns and the best treatment options available for you, go to our online bookings page or contact us on (08) 9208 6400.

To find out more about our dermatology services, visit the Dermatology page of our website>>

To make a booking for a free initial consultation with our sister skin clinic – DermCosmesis – click here>>

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