Melasma: What Are Your Options?

October 1, 2010

Melasma, also commonly known as chloasma, is a skin discoloration making the skin darker. When melasma occurs when a woman is pregnant, it is called chloasma. Melasma manifests as a circumscribed level, nonpalpable patch that is brownish in color and that has uneven borders. The frequent places where melasma develops include the cheeks, chin, forehead, nose and lips. But it is a relatively good thing for it is not cancerous, not tender, not itchy and not accompanied with other symptoms but the bothersome patch itself. Melasma is usually found in women than men – with these women being pregnant or women subjected to either contraception or hormonal replacement.

Melasma develops bit-by-bit. Several studies state that they still cannot give the definite cause of melasma but can only give its most feasible causes based on the cases. The most crucial factor that most of us are familiar with is overexposure to the sun’s damaging rays calling for the need to produce melanin. The same reason, melanin overproduction, but this time, a different cause – the hormones estrogen and progesterone – is another probable explanation for melasma growth. Various experiments also showed that the genes is an important factor in the formation of melasma. Another cause worth mentioning is a thyroid gland abnormality leading to overproduction of the hormones and the anticipated stirring up of the cells responsible for the generation of melanin.

In today’s time, anyone can pick from various treatment regimen 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 comes in two percent, four percent or greater concentrations. When you decide to use higher concentrations of hydroquinone, be aware that this not only maximizes its effectiveness but it also increases your risks of handling the adverse effects.


Tretinoin reduces skin discoloration by stimulating production of collagen and removing keratinocytes or removing the skin’s outermost layer. But tretinoin cannot overcome the power of hydroquinone. As a result, tretinoin comes in combination with hydroquinone. Azelaic acid’s mechanism is the decrease in the normal functioning of the melanocytes and this is regarded more effective than the two percent concentration of hydroquinone. But they all similarly cause minor skin alterations such as irritation, itching and redness. Another treatment option is the use of chemical peels to gently exfoliate the skin and therefore remove the discoloration. Here, the type of peel depends on the doctor’s assessment of the individual. Another type of desquamating the skin is the dermabrasion which uses a vacuum and a handheld scraper instead of chemicals. Laser therapy is also available but most do not recommend this for it has not really been successful in removing the skin discoloration. 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. They are also costly. In the end, topical creams with hydroquinone triumphdominate in the war of successfully treating melasma.

But no matter what treatment you choose, always remember that effects are not achieved overnight. Moreover, since the production of melanin is decreased, you have to protect your skin more from the sun.

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