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Medical Dermatology


What is Melasma?

Melasma is a form of hyperpigmentation (darkened or discolored skin) that causes symmetrical, blotchy grey-brown patches of discoloration on the face exposed to the sun. The discoloration is caused by an excess of melanin, the compound that gives the skin its color. It appears in a characteristic pattern on the cheeks, bridge of the nose, forehead, chin and above the upper lip. On occasion melasma can be found on the skin of the arms and neck. Melasma is a chronic skin condition.

Melasma causes no side effects beyond the skin discoloration. However, melasma sufferers report embarrassment, emotional distress, and poor self-esteem and quality of life. Unlike hyperpigmentation, melasma is triggered by and worsens with exposure to the sun.

While melasma can fade spontaneously, it is stubborn and can reappear.  Typically, melasma is more obvious in the summertime and tends to fade during the winter. However, with good care and treatment it can be managed.

Who is at risk for melasma?

Melasma commonly affects women, especially women with deeper skin tones. However, melasma can also affect men.

What causes melasma?

Hormonal influences and UV light exposure prompt the development of melasma. Estrogen seems to be the culprit in hormone changes, including the estrogen in oral contraceptives, hormone replacement therapy and pregnancy. Melasma is called the “Mask of Pregnancy”. Other triggers include sun exposure, UV light exposure from computer screens and cell phones, heat, some medications.

How is it treated?

During your consultation, Dr. Ritu Saini will listen to your concerns and examine your skin. With your help, she will attempt to identify the triggers that may be responsible for your melasma including your use of birth control pills or hormone replacement therapy. If pregnant, your melasma may fade post-partum, and in any event the treatments are not safe for use during pregnancy.

Typical treatment strategies include avoiding known triggers, wearing sun blocking sunscreen, using skin lightening creams and retinoid creams. However, even when these works to diminish the appearance of melasma, the problem can return when treatment stops. Procedures such as chemical peels, microneedling and laser therapy may provide more lasting results.

A new drug called tranexamic acid with sunscreen containing iron oxide is effective in 49% of cases to improve the appearance of melasma.  Ask Dr. Saini about this treatment option.

It is important to stay out of the sun, be diligent about sunscreen application, and avoid other triggers. No single treatment is effective for every melasma sufferer, so once you find something that works, stick with it to maintain results.

Dr. Saini is a board-certified and fellowship-trained dermatologist in New York City. Contact her office to schedule a consultation to learn about melasma and how she can help you improve your condition.

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