Melasma is a common skin condition that affects women between the ages of 20 and 40, and its effects are more pronounced on people that have a naturally darker skin tone. In melasma, sun exposed skin, most commonly the face, develops patches of skin that are much darker than the other areas. The darkening of the skin is usually patterned, affecting the cheeks, upper lip, nose, and chin area. In rare occasions, the forearms can also be affected. Melasma is primarily caused by over-exposure to the sun, however other factors can contribute to its development, such as hormonal changes (pregnancy), genetic predisposition, as well as irritating skin-care products. While the condition is not life threatening, it can affect greatly affect a person’s appearance, which can negatively impact their social and emotional life.

Common symptoms of melasma include:

Spots on skin: Irregularly shaped light to dark brown patches of skin

Areas of occurrence: Commonly shows up on areas of the face such as the forehead, temples, cheeks and chin. Melasma may also be seen on the forearms.

Melasma is primarily caused by over-exposure to the sun, however other factors can contribute to its development, such as hormonal changes, genetic predisposition, as well as irritating skin care products. In some cases, it only takes a few minutes of sun exposure to result in pigmentation changes. Melasma can be prevented with proper sun protection and skin care.

Good skin care is essential for maintaining healthy, beautiful skin. Avoid perfume products as they can be photosensitizing. Keep your skin clean and clear by using gentle cleansers and exfoliators. Use a daily moisturizer to keep your skin adequately hydrated. Protect your skin from the sun by using a sunscreen that offers protection against harmful UV rays.

The first step to preventing melasma is good skin care and adequate protection from the sun and UV light, especially UVA rays.

Limit sun exposure: Reducing your time in the sun is perhaps the easiest way to avoid damage to your skin caused by UV rays. When outdoors, set a time limit and seek shade when necessary. Also keep in mind that UV radiation is the strongest between the hours of 10 a.m. to 4 p.m.

Use Sunscreen:Sunscreens are an essential part of protection against the sun. Look for sunscreens that are labeled “Broad Spectrum”. They are often the most effective and offer protection against both UVA and UVB rays. Make sure to apply generously and frequently.

Cover and protect: Wrap-around sunglasses, wide-brimmed hats and clothing that covers your arms and legs, can offer extra protection against the sun’s harmful UV rays.

OTC
Over the counter products that contain Hydroquinone, Arbutin, Vitamin C and Kojic acid are helpful in reducing the appearance of melasma.

Prescriptions
Hydroquinone combined with retinoids and a mild topical corticosteroid is a classic combination used to treat melasma. However, these products will not work if there is ongoing stimulation from UV light (especially UVA).

Procedures
In some cases, Intense Pulsed Light (IPL) treatments can improve melasma and other facial pigmentation problems. Fractional resurfacing may help at least in the short term, but does not offer a viable long term benefit. In all cases, sun avoidance and consistent use of sunscreens are the most important steps to preventing and treating melasma.