Melasma Skin: What, Why, How? | Dr Hala Aesthetics
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  • Writer's pictureAli Rislan

Melasma Skin: What, Why, How?

Updated: Nov 28, 2023

Melasma can be a difficult condition to deal with and live with. It is currently incurable, so you may be feeling a little lost and helpless with it. But, that doesn't mean you just have to resign yourself to living with it.

Melasma | A photo of a person with Melasma on their cheek.

In this article, you'll learn answers to questions such as:

  • What is Melasma? People sometimes group it together with hyperpigmentation, but there is a difference.

  • Why do I have Melasma? You'll learn about the process of its development and its causes.

  • How can I treat Melasma? You can't cure it but you can reduce its appearance, such as with specialised treatment for Melasma.

So keep reading to learn all you need to know about this skin condition.


What is Melasma?

Melasma, sometimes called Chloasma, is a skin condition that is extremely similar to hyperpigmentation. You might see it referred to as a more specific type of hyperpigmentation. It is significantly more common in women and individuals with darker skin tones but can occur in men too.


You'll have patches of irregular face pigmentation in areas affected by both of these skin conditions. You'll commonly see discolouration on the cheeks, nose, around the lips, and forehead. Despite their similarity, Melasma is a little unique:

Melasma | An illustration of the cellular difference between normal skin and melasma skin.
  • There does not need to be direct skin damage for you to develop Melasma. Hyperpigmentation however is a result of sun damage, or post-inflammatory hyperpigmentation such as from acne damage. Melasma can be a result of sun damage, but also hormonal fluctuations. We'll come back to this a little later!

  • It commonly appears as broad patches of darker-coloured skin. Hyperpigmentation instead appears as localised areas of darker skin, such as dots or circles.

As you learned, the characteristic sign is broad patches of darker skin. These can be light to dark brown, or even grey in some individuals.


Why Do You Have Melasma?

You learned a little about this when we distinguished it from hyperpigmentation earlier. People often refer to Melasma as sun damage on the face, but there's more to it than that. The cause is an overproduction of pigment in the deeper layers of your skin. We call this pigment melanin, and it is a protein that gives your skin its natural colour and tone.


Melanin Production & What Can Go Wrong

You have cells in your skin called melanocytes, and they are responsible for producing melanin. Under normal conditions, they produce enough melanin to maintain your inherited skin tone. You may develop or exacerbate Melasma when something goes wrong in the normal melanin production process:

Melasma | An illustration of the sun's UVB rays causing pigmentation and Melasma at the cellular level.
  1. Hormonal fluctuations can cause skin pigmentation and Melasma. The responsible hormones are commonly oestrogen, progesterone, and melanocyte-stimulating hormone. These hormones fluctuate significantly during pregnancy and are a strong explanation for why women are most affected by it. This is also why people have coined it the "mask of pregnancy". The body significantly increases melanin production, but science has not yet determined the exact mechanism. Research has also linked oral contraceptive use to the development of this condition.

  2. Chronic stress can lead to Melasma development, and worsening. The fact is that chronic stress is not good for you at all. Long-term elevations in Cortisol, the stress hormone, can negatively impact your health as well as your melanin balance.

  3. Sun exposure can cause an overproduction of melanin. Your skin does this as a defence mechanism against sun damage. This is because melanin is protective against UV rays that could otherwise damage your skin when exposed to the sun. This protects you from burning and even developing conditions such as skin cancer. This doesn't directly cause Melasma, but exacerbates it to an extent that makes it worth including here!

A combination of these three may be responsible for more severe cases. You may already have some ideas for protecting your skin, and we haven't even reached the next section yet.

Evidence also suggests that it is a hereditary condition. This means you're more likely to have it if members of your family do too.


Now you know what Melasma is, and why you have it, how can you reduce its appearance?


How Can You Manage Melasma?

A good Melasma treatment plan is key for managing it, with treatments suitable for your skin. Treatments suitable for you are the important part, there isn't one laser or "best facial" for pigmentation. Once again, we say manage as we haven't yet learned how to cure Melasma from the inside of the skin.


You may have heard about these treatments on the Melasma NHS website, but they are missing some details. The process is similar to treating hyperpigmentation, but it's a lifelong commitment for people with melasma:


Laser Treatments for Melasma

Melasma | A person having a laser treatment that is good for Melasma.

Laser treatments such as the ClearLift laser are great for managing Melasma. It works by shattering melanin at deeper levels of the skin to even out skin tone. The laser breaks down melanin, and then your immune system clears away the fragments.


The treatment actually brightens and evens out the skin in the entire treated area! Your doctor or aesthetician might recommend laser treatment after a peel for best results.


Peels

Melasma | A person having a green peel treatment.

Peels are great for treating the condition, and also preparing your skin for laser treatment. They'll encourage your skin to renew its top layers, which brings the melanin to the surface. Following up with further peels or laser treatment is much more effective when the melanin is closer to the surface.


Peels such as the herbal Green Peel or chemical PRX T-33 peel are great options here.


Anti-Melasma Creams

Some creams are great for managing Melasma, often used as a supplement to laser and peels. Creams for Melasma that contain Azelaic Acid or Tranexamic Acid have shown good results. Look for medical-grade products in this case, consulting with your GP or aesthetic doctor can be invaluable here.


Taking Precautions

Melasma | A muslim woman wearing a hijab and a hat to protect her skin from the sun.

You can't always prevent melasma, because of hormonal causes, but you can take precautions to stop it from worsening. The number one piece of advice is to properly protect your skin from the sun. This can mean:

  • Avoiding prolonged periods of sun exposure to high-risk or affected areas.

  • Wearing SPF, and clothing such as a wide-brimmed hat to prevent direct sun exposure.

You may also remember that Cortisol can worsen Melasma and your health. We recommend stress-relieving and calming practices for improving skin conditions, and general health.


So can you now define what Melasma is, why some people get it, and how to manage it? You should be far more confident in doing so after reading this, but you might still have a couple of questions. Just click the button below and fill out the form to get some expert advice, tailored to your skin.

Enjoyed reading this article, or have suggestions for something we could improve or include? Leave us a comment below and we'll get back to you during the week!


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