Melasma blog written by Cristy Viney

Melasma

Melasma is a condition that is super close to my heart, as it is something I myself battle with. My melasma reared its ugly head when I had my son over 13 years ago now, and I have made it my mission to find out as much as I can about this condition since. It is an ever-developing skin condition, one that the experts are still learning about to date.

So, for those of you who have this condition, this blog is for you! And I know you will be as passionate as I am about it.

Melasma is a pigmentation disorder of the skin that unfortunately mostly affects women, and especially those with darker skin. It is commonly seen on the face and usually presents as dark spots and patches with irregular borders. It is symmetrical in appearance in other words, if it appears on one cheek, it will also appear on the other.  Melasma tends to appear on the face. The most common locations include the upper lips, bridge of the nose, cheeks, and forehead. But don’t for one second think it is only reserved for only the face. Melasma can also appear on other parts of the body that are exposed to the sun, although less common, places like the forearms, shoulders and neck are some other areas it can be found.

Melasma pathway

So how exactly can we tell the difference between regular pigmentation and melasma you may ask yourself, pigmentation is pigmentation, right? No unfortunately this is not the case.

The differences between the two are, melasma patches are often brown or grey in colour and looks almost like it is coffee grounds smudged into the skin. Whereas other pigmentation covers a variety of different discolouration in the skin that can be splodged just about anywhere on the skin and it can be triggered more via injury, sun damage, certain skin conditions like eczema and psoriasis, senile lesions and many more.

Whereas melasma shows to be more pronounced in women and tends to be triggered by hormones via contraceptive pill and pregnancy, certain medications, UV exposure and has a higher tendency to be hereditary.

Although Melasma and Pigmentation can look and act alike, they are two very different skin conditions and are to be treated as such.

It is not yet fully understood as to why melasma occurs. Nor is there a cure for it, we do know that the melanocytes (the colour-making cells) malfunction in the skin and this causes them to produce too much colour in certain spots. It also tends to be more hormonally driven, and unfortunately the triggers and controllability are so variable it makes it a pigment disorder that is never fully treatable. Melasma can be found in the epidermis (the upper layers of the skin) which makes our job easier to treat it, or in the dermis (the lower layers of the skin) which is very challenging to treat, and you will more often than not find it in a combination of both regions, But we have to just learn how to managed it as best we can and develop a better understanding of the triggers and how we can reduce them as much as we can. This is where your therapist step in to educate you as best, we can and give you the tools for the very best outcome.

Potential triggers and factors for melasma can include:

  • Changes in hormones during pregnancy up to 15% to 50% (chloasma)
  • Hormone treatment or taking contraceptive pills.
  • Sun exposure frequent exposure to UV rays can trigger melasma.
  • Genetics Up to 50% of people with melasma report that close relatives also have the condition.
  • Gender Melasma affects females about 9 times more than it does males.
  • Certain skin care products, aggressive treatments, heat-based laser treatments.
  • Some medications, like those that make the skin more sensitive to sun exposure.
  • Melasma becomes worse during the summer and less visible during the winter or less sunny periods.
  • Medications and scented products — new targeted therapies for cancer and perfumed soaps, toiletries, and cosmetics may cause a phototoxic reaction to trigger melasma.
  • Fitzpatrick 4-6 higher chances of developing melasma 1-3 smaller chance but still not immune to developing it.

So, what can we do to minimise the effects of melasma?

  • Reduce sun exposure.
  • Find the trigger with the help of your GP, Therapist or Naturopath.
  • Make sure you are on a tyrosinase inhibitor.
  • SPF every single day no exceptions.
  • Other actives that are amazing are Vit A,B,C Kojic acid, hydroquinone, azelaic acid, niacinamide, cysteamine, rucinol, and tranexamic acid. These ingredients work by reducing pigment production and inflammation, and by reducing excess blood vessels in the skin that contribute to melasma.
  • No heat-based therapies as they carry a high risk for relapse and melasma can become more resistant to treatment.
  • Turn on blue light filter to block blue light from device screens.

Effective Treatments

  • Non heat-based therapies.
  • Cold Peels
  • Cosmelan, Dermelan, Melanopeel or Elaine Brennan.
  • LED
  • Guidance with your G.P, Dermatologist, Clinical Nurse, Dermal therapist, Naturopath for effective topical treatments, skincare, gut health and correct medications and medical treatments.
Cosmelan, Melanopeel or Dermelan Clinic Treatment

What is the outcome for melasma?

Melasma can be frustrating to treat, for yourself and your practitioner. It is slow to respond to treatment, especially if it has been present for a long time. And even in those who get a good result from treatment, pigmentation may reappear on exposure to summer sun.

The risk for relapse and the need for lifelong sun protection needs to be the very first hurdle and your practitioner should set realistic goals and outcomes. We always first need to determine what your individual trigger is and then address it correctly form a treatment plan and a prevention plan to help guide and minimise the effects of your Melasma.

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