Melasma treatment

If old wives’ tales are to be believed, pregnancy elevates women to a rarefied state of radiant beauty. In reality, hormonal changes during pregnancy can wreak havoc on women’s skin, with melasma or chloasma, among the more common complaints. Also known as pregnancy mask, melasma affects 70% of pregnant women, favoring those with darker skin tones. The unsightly, brown to gray patches are caused by overproduction of the pigmentation hormone due to increased levels of estrogen or progesterone. Not surprisingly, melasma treatments have been incorporated in the health care regimen of obstetric patients.

Women seeking treatment for melasma are a diverse group because this condition is caused by many factors. Contraceptive use, hormone replacement therapy (HRT), allergic reaction to medications and cosmetics can trigger melasma development. In some cases, thyroid disease and stress can precipitate the need for melasma treatment. That said, melasma is not exclusively a female malady. A small population of males may require melasma treatment at some point. Heredity, ancestry and sun exposure are male risk factors for this skin problem. In both males and females, sun exposure aggravates the condition because ultraviolet rays promote excessive melanin production by melanocytes.

Generally, melasma will resolve on its own post- pregnancy and after termination of contraception or HRT. It is usually innocuous and is not known to cause other symptoms. But since brown patches on the face are too conspicuous to ignore, many treatments for melasma have been tried and tested. Topical creams containing depigmentation ingredients such as tretinoic, kojic and azelaic acids are commonly used. Topical steroids can fade discoloration and prevent medication-induced dermatitis. With more vexing cases, doctors may recommend chemical peels as part of the treatment for melasma. Additionally, truly severe conditions may call for laser therapy to eliminate dark pigments. Treatment entails time and diligence as the condition tends to recur.

While there are many treatments and therapies available, judicious sun protection is still the first line of defense for those susceptible to melasma. The condition may not be entirely preventable for those who are predisposed, but managing the factors that exacerbate melasma is a good start.