Melasma is a very common condition that primarily affects women. It is characterized by increased pigmentation in the form of light to dark brown patches on the forehead, temples, cheeks, upper lip, or chin. Treatment consists of creams and occasionally the use of laser.
There are several potential causes. Ultraviolet radiation is the most important cause of this skin condition and sunlight, even through the window, or fluorescent lighting will sometimes darken the skin. In fact, even if melasma has been completely faded with treatment, exposure to significant amounts of sunlight can cause the pigmentation to recur. Other factors include hormones (e.g. pregnancy or birth control) and genetics.
The first step in treatment is to reduce sun exposure as much as possible and to wear suitable broad spectrum sunscreen. In addition, topical bleaching agents can be used to fade the excess pigment. Agents such as hydroquinone, tretinoin, and kojic acid can all help. We have a medicated cream that will often control melasma. On average, 80% of patients are usually 80% lighter within eight months, in cases where bleaching agents and sunscreens are used. Alternative therapies include PicoWay laser and IPL (intense pulsed light), although these therapies are not always effective. Sometimes they appear to work initially but the pigmentation quickly recurs and if used inappropriately, laser and IPL can even make matters worse.