Melasma, also usually called chloasma, is a hyperpigmentation of the skin making the skin’s color uneven. The term chloasma is most used when indicating melasma obtained throughout the span of pregnancy. Melasma manifests as a circumscribed level, nonpalpable blotch that is brownish in color and that has erratic borders. It is usually located on the facial region particularly the cheeks, chin, forehead, nose and lips. However, other than the unsightly appearance, there is no pain, itching or other accompanying symptoms. Melasma is commonly found in women than men – with these women carrying a child or women subjected to either contraception or hormonal replacement.
The development of melasma is a gradual process. Just like many other diseases, the elusive definite reason for the development of melasma has ever since evaded the specialists’ grip. The most well-known is the overproduction of melanin when there is overexposure to the sun. Another is the overproduction of melanin caused by the hormones estrogen and progesterone during pregnancy or when one is using contraceptives or hormonal replacement drugs containing these hormones. Another persuasive cause is the history of having melasma in the family. Another cause worth telling is a thyroid gland problem resulting to overproduction of the hormones and the impending stirring up of the cells responsible for the existence of melanin.
In today’s time, anyone can choose from various treatment options to bolt the “removal” of a melasma. One is through the use of topical creams containing chemical compounds such as hydroquinone, tretinoin, or azelaic acid. Hydroquinone works by decreasing melanin production through the inhibition of tyrosinase – the enzyme that produces melanin. Hydroquinone can be purchased in two percent, four percent or greater concentrations. When you opt to use higher concentrations of hydroquinone, be informed that this not only boosts its effectiveness but it also increases your risks of experiencing the adverse effects. Tretinoin helps remove the discoloration caused by melasma by creating more collagen and by increasing the rate at which keratinocytes are removed. But tretinoin cannot overwhelm the power of hydroquinone. The combination of tretinoin with hydroquinone is therefore more preferred than topical creams containing tretinoin alone. Azelaic acid, a stronger skin lightener than two percent hydroquinone, works by stopping the melanocytes from functioning properly and therefore, decreasing melaning. But all these three have minor negative effects such as skin irritation, itching and redness. Chemical peels are now attainable to help remove the presence of a melasma by mildly exfoliating the skin. Here, the type of peel depends on the doctor’s assessment of the individual. Having the same mode of action as chemical peels, dermabrasion exfoliates the skin but with the use of a vacuum and a scraper – a manual process. Another treatment regimen is laser therapy but which does not yield successful results and at the same time, increases your risks for developing possible complications. In general, most of these treatments, if not done properly can produce complications such as scarring, tissue necrosis and skin hyperpigmentation for the second, third or so on time. Moreover, they are much more expensive. Therefore, currently, the use of hydroquinone remains to be the best treatment for only a few had been witness to its side effects.
But whichever of the above treatment options you choose, do not forget that effects are achieved slowly for melasma’s coming into existence is also a gradual process. Lastly, to not waste the work being done by the treatment, strict avoidance of the sun is recommended.