Melasma is a common skin condition causing brown to grayish patches that usually affect the face. It is much more common in women, with only 10% of cases in men. People with darker skin tones such as those of Asian, Indian, Middle Eastern and Mediterranean descent are more prone to developing melasma.

 

The exact cause of melasma is still unknown. Genetics plays a major role in the development of melasma with more than 30% of patients having a family history of melasma. Sun exposure is another major triggering factor. Other common causes include pregnancy, birth control pills, hormone therapy, and cosmetics that cause a phototoxic reaction.

 

How to treat melasma?

Treating melasma requires patience and a combination of treatments tailored to your skin type.

Sun protective measures, such as avoiding the sun and wearing sunscreen on a daily basis, are essential in reducing the risks of exposure to the sun’s ultraviolet rays. Even if most of the day is spent indoors, a brief walk, driving, or sitting next to a window may expose unprotected skin to enough sunlight to trigger melasma. Use a broad-spectrum sunscreen that protects against UVA and UVB rays with a minimum SPF (sun protection factor) of 30 or more.

Various prescription creams with pigment lightening effects can be used alone or in combination to improve melasma:

  • Hydroquinone

  • Tretinoin

  • Azelaic acid

  • Kojic acid

  • Ascorbic acid (vitamin C)

  • Alpha hydroxyacids (AHA) such as glycolic acid

A topical corticosteroid may be added in certain cases to reduce the irritation caused by some of these agents.

 

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