Melasma in simple words is an intense tan, discoloration or dark skin, resulting from more exposure, usually and it is mostly a challenging complication for dermatologist to treat. These spots are darker compared to the normal complexion of the skin and occur, mostly on cheeks, upper lips and other parts of face and neck. These dark spots are not created just like keloids and no cause no pain, itching or soreness. However, the spots make the person to be self-conscious and develop tendency to avoid mingling in public and public gatherings to prevent possible stares from onlookers. Normal cosmetic lotions and creams cannot clear the spots.
The prime cause of the dark spots is prolonged exposure to sun-rays. Melasma is a condition of stimulation of melanocyte cells, when sun ultraviolet light is exposed to the sun.
Some of the Melasma cases are occurred during pregnancy period and no treatment is required, as they get disappeared after a few weeks of delivery. So, these marks of Melasma are also called as pregnancy marks and quite known in the patient community.
Melasma can be developed by genetic predisposition also. It is possible that two siblings may get affected by Melasma, though parents have no signs of the same. Basically, Melasma is caused and perceived as a rise in levels of oestrogen, which usually gets easily triggered by hormone replacement or oral contraceptive patches or pills medication.
The symptoms of Melasma are more in summer and lesser in winter as these are more intense and caused from the severe and brighter sun. These are just visible symptoms, but are neither contagious nor threatening to the lives. The patches developed from Melasma are in dark or light brown to grey pigmentation for the skin of darker skin, especially for the people in tropical climates.
Patches vary from 0.5 cm to 10 cm, in size. Symptoms are more common on nose, cheeks, forehead, chin and upper lips.
To ascertain actual cause of the dark spots and level of complications, biopsy is needed. Local anaesthesia is given and then tiny skin sample is removed after numbing, to determine that the cells are not cancerous.
Though Melasma cannot be completely cured, the defects of the spots can be reduced to retain the complexion and beauty of the skin.
The first line of treatment is prescribing sun blocking cream for camouflaging the effected skin against the damaged skin, by the dermatologist. It can reduce the intensity of the pigmentation through skin lightening agents, and slowly bring the same in line with the skin in surrounding areas. An important and interesting compound here is Hydroquinone cell, which reduces the pigment forming and is well known as potential skin lightening agent. The same compound must be very carefully handled under medical supervision, since any deviations may cause increased darkness or irritation on darker skins.
Since Melasma is basically caused from oestrogen level rise, the following medications stand as the first step to get rid of Melasma.
- Skin bleaching cream, which contains azelaic acid mixed with cream of retinoid. It helps treating acne and hence it works effective in Melasma curing. These creams help to remove the outermost skin area, which contain the pigment in excess.
- In case bleaching creams are not found effective, the second line of attack is chemical peels.
- Finally, the defective cells that form the pigment that are present on the outermost skin layers can be removed through laser and dermabrasion treatments.
All these treatments should be administered and supervised by only expert dermatologists, otherwise the side effects can be quite possible and result in distressing.