Frequently Asked Questions
1. What is Melasma?
Melasma is a chronic skin condition that causes dark, gray-brown patches to appear on the skin. It’s commonly associated with sun damage as too much sunlight exposure can cause the skin to produce more pigment and darken the facial skin.
Some cases of melasma can be mistaken for freckles as it can also form small spots on the skin. However, melasma patches are typically larger than the usual sun spots, freckles, and age spots.
Women are more likely to develop patches of skin discoloration than men. Melasma is also thought to be linked to hormonal changes and can often occur in pregnant women. This skin condition is sometimes called the mask of pregnancy.
Different Types of Melasma
Melasma can be categorized into three main types depending on the depth of the pigmentation. During a skin consultation with a dermatologist, they can determine the type of melasma that you have with the help of a Wood’s lamp. Here are the three common classifications of melasma:
Epidermal Melasma
This form of melasma commonly appears on the superficial layers of the skin. It usually develops a dark brown patch with a noticeably defined border. Under Wood’s lamp examination, epidermal melasma can be instantly visible on the skin. Since this is somewhat a milder form of melasma, it can clear up with proper treatment.
Dermal Melasma
Unlike epidermal melasma that forms on the top layer of the skin, this type of hyperpigmentation occurs due to the increase of pigment in the deeper layers of the dermis. They usually have a light brown or bluish color with a slightly blurred border. They will look the same under the black light and they may not be easily eliminated with treatment.
Mixed Melasma
As its name suggests, mixed melasma is a combination of dermal and epidermal hyperpigmentation. Its patches can appear brown to bluish on the skin. It will show a mixed pattern under Wood’s lamp and it can be improved with treatment.
2. What Causes Melasma?
Melasma is related to the melanocytes or the pigment-producing cells in the skin. Melanocytes are found in the basal cell layer at the epidermis and they are mainly responsible for creating melanin that gives the skin its color.
It’s highly likely that dark patches of melasma appear when the melanocytes are stimulated and produce too much pigment. There are several factors that can contribute to the overproduction of these skin cells like
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Sun exposure - The ultraviolet light from the sun can cause the skin to produce more melanocytes and worsen the existing symptoms of melasma.
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Hormone changes - Pregnancy can cause hormone fluctuations and the increased levels of estrogen and progesterone can influence melanin production. Additionally, taking birth control pills and hormone replacement therapy can lead to melasma.
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Use of certain skincare products - Some cosmetic or skincare products can irritate your skin and cause discoloration or phototoxic reaction (similar to a sunburn or rash).
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Tanning beds - The UV light from tanning beds can be just as damaging to your skin as frequent sun exposure.
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LED Light - Blue lights from bulbs, computer screens, television, and other electronic devices can likewise cause melasma.
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Scented soaps and fragrances - The use of deodorant soaps, scented fragrances, and other cosmetics may also trigger melasma symptoms.
3. How to Diagnose Melasma ?
It’s easy for dermatologists to diagnose melasma with a simple visual examination of the existing pigmentation on your skin. They may also use the Wood’s lamp to analyze the changes in the color of your skin and identify which type of melasma you have.
It can also reveal the extent of damage from sun exposure on the skin and determine the depth of pigmentation that’s not visible to the naked. This diagnosing technique can also help check if you have a bacterial or fungal infection that’s causing the pigmentation.
In more severe cases, a small sample of your skin may be removed for a biopsy. This test can help rule out other skin conditions that can also cause pigmentation issues. If you have thyroid problems, you may get it checked by your healthcare provider and see if it is affecting your melasma.
4. Does Melasma Come Back After Treatment ?
Yes, melasma can often return after treatment, even after successful fading of the dark patches. Melasma is a chronic condition, and treatments may only offer temporary relief.Relapse is common, especially if protective measures like sunscreen are not consistently used.