Melasma is a facial condition that causes brown patches of hyperpigmentation on the skin. It usually appears on the cheeks, across the forehead and upper lip, or can appear in single patches. Commonly associated with hormonal factors, it can occur during pregnancy, during hormone replacement therapy. Causes of melasma appear to include a genetic predisposition, sun exposure (anything from decades ago to your most recent sun tanning session), hormonal changes, certain medication and medical conditions such as hypothyroidism. It is much more common in women, but can also appear in men.
“Unfortunately, melasma is notoriously difficult to treat, since it is triggered by hormones and by the sun”, says Dr Michelle Lim.
The first step to treating melasma would be to see your skin doctor and have your hyperpigmentation looked at. Then exacerbating factors such as medication can be looked at, recommends Dr Michelle. She always prescribes a no-sun therapy – i.e. a strict sunscreen regimen. While both chemical and physical/mineral sunscreens are effective for normal skin, physical sunscreens are preferred by some doctors because they filter out the harmful rays altogether, provided you use enough of it. This is important in a heat-sensitive condition such as melasma. These sunscreens are non-chemical and contain zinc oxide and titanium dioxide.
One of my pet peeves about physical sunscreens is the pasty white cast the leave behind. To combat this, you can find a tinted mineral sunscreen, and/or add further protection by layering makeup after which also contains sunscreen.
Laser treatments have shown some promise at eradicating these pesky dark patches, although pigmentation can rebound after clearance. Melasma is hated because it is recalcitrant. Patients with melasma should be treated conservatively, therefore aggressive laser treatments and peels should be avoided. This is why the SW1 clinic uses state-of-the-art lasers for treating pigmentation. Their Porcelain Skin Program uses a gentle picosecond laser which generates less heat at the 1064 wavelength and removes pigmentation via a sophisticated photo-acoustic effect. Another popular treatment is their thulium BB Aquatouch laser, which gently scrubs away stubborn pigmentation, unmasking melasma using the 1927 wavelength.
Our skin takes a lot of stress in our urban environment, so combat these with antioxidants, such as Red Tourmaline which contains Astaxanthin extracts, an antioxidant powerhouse. Even with treatment, melasma may take months to clear up so be patient, and most importantly, be diligent with sun protection.