WHAT IS MELASMA?

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Melasma is a common skin condition that causes brown to grey-brown patches, usually on the face. These patches most commonly appear on the cheeks, forehead, bridge of the nose, and above the upper lip. Melasma occurs when melanocytes (pigment cells) produce too much pigment. It is more prevalent in individuals with skin of colour, more common in women, and can be triggered by hormonal changes, sun exposure, and genetic predisposition.

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UNIQUE CONSIDERATIONS FOR SKIN OF COLOUR

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People with skin of colour are more likely to develop melasma because their skin produces more melanin, which can be easily triggered by things like sun exposure, hormonal changes, or skin irritation. In darker skin tones, melasma often appears as dark brown or greyish patches that stand out more against the natural skin tone. Treating melasma in skin of colour needs extra care. Darker skin is more likely to develop further dark spots if treatments are too harsh or irritating. That’s why it’s important to use gentle, targeted therapies that work without causing additional discolouration.

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​CAUSES AND TRIGGERS

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Melasma is caused by factors such as sunlight and hormonal changes in genetically susceptible individuals. It often runs in families and is linked to hormonal changes such as pregnancy or oral contraceptive use. Sun exposure, both ultraviolet (UV) and visible light can trigger and exacerbate melasma. This can be from sun exposure during daily activities, both outdoors and indoors.

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WHO CAN GET MELASMA?

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Women of darker skin types are predominantly affected, however men get melasma too.

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​WHAT DOES IT LOOK LIKE?

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Melasma presents as brown to gray-brown patches on both sides of the face. These patches can vary in size and intensity, often becoming more noticeable after sun exposure or during periods of hormonal changes (e.g. pregnancy).

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EFFECTS ON EMOTIONAL WELL-BEING

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Living with melasma can lead to emotional distress, affecting social interactions, self-esteem and confidence.

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DIAGNOSIS

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Diagnosing melasma involves a visual examination by a dermatologist. In some cases, a skin biopsy may be necessary to confirm the diagnosis and rule out other conditions.

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TREATMENT

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Treatment options aim to lighten existing patches, prevent further pigmentation, and protect the skin from sun exposure. Effective management of melasma requires a multifaceted approach tailored to individual needs.
Common treatment modalities include:

• Sun Protection: Daily use of broad-spectrum sunscreen protection against UV and visible light (SPF 30+ and iron oxide containing) is crucial to prevent melasma.

• Topical Treatments: Prescribed triple combination cream (containing hydroquinone, tretinoin and steroids) is considered an effective first line treatment, usually recommended for 3-6 months. Other lightening agents such as azelaic acid, kojic acid, tranexamic acid, arbutin are helpful in mild melasma or for maintenance treatment

• Hormonal Management: Adjusting or discontinuing hormonal therapies may be necessary under medical supervision.

• Oral tranexamic acid: This is an effective option in cases of severe or difficult to treat melasma.

• Procedures: Chemical peels and laser treatments are options for resistant melasma. These procedures should be performed cautiously by experienced dermatologists to minimise the risk of worsening pigmentation.

• Cosmetic camouflage: It helps by masking the pigmentation thus improving the quality of life.

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SELF-CARE TIPS

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In addition to medical treatment, self-care practices are helpful for managing melasma and maintaining skin health.

• Daily use of an appropriate sunscreen, both outdoors and indoors is important, since even small doses of light can worsen melasma.

• Reapply sunscreen at least 3-4 times a day, and after swimming or sweating.

• Using protective clothing, hats, and sunglasses to minimise sun exposure. Visors and tinted windows can protect from ultraviolet light while driving.

• Gentle cleansing with mild, non-irritating cleansers, and daily moisturizers to improve skin barrier.

• Avoiding harsh scrubs or abrasive treatments that can worsen pigmentation.

• Seeking emotional support from healthcare providers, support groups, or loved ones to cope with the emotional impact of melasma.

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CONCLUSION

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Melasma is a chronic, persistent skin condition that requires a tailored approach to treatment, especially for individuals with skin of colour. By understanding the causes and treatment options for melasma, you can take proactive steps to manage your condition effectively and minimize its
impact on your daily life.