Melasma is a common skin condition that’s completely harmless and doesn’t indicate any other health issues. However, most patients with melasma would prefer it to disappear. Drugstores and cosmetic counters are full of treatments for melasma, but do any of them work?
At Vibrant Dermatology in Dedham, MA, we want to reveal your best skin by offering state-of-the-art solutions to your skin concerns. We know it’s essential to understand all of your options, so here we will explain melasma and its common treatments.
Melasma is a skin condition that causes light brown, dark brown, or blue-gray patches on the skin. It presents as flat patches or freckle-like spots and is most common on the face, including the cheeks and forehead.
Melasma is often called the “mask of pregnancy” since it affects 15-50% of pregnant women. In addition, melasma often darkens in the summer in response to sun exposure and lightens in the winter.
A dermatologist’s visual exam often diagnoses melasma. However, Dr. Ip may need to use a specialized device, such as a dermatoscope, to look at your melasma closely. A dermatoscope or Wood’s lamp lets her see how deeply the darker pigment permeates your skin’s layers.
In some cases, melasma mimics other skin conditions, and a biopsy may be necessary for a confident diagnosis. In that case, we’ll remove a small amount of skin during a skin biopsy for further examination.
While melasma may look similar to freckles, they are different skin conditions. Melasma is also not the same as liver or age spots. These skin conditions look similar, but melasma is almost always larger than most age spots.
Depending on the cause of your melasma, it may go away on its own. For example, melasma triggered by medication or pregnancy usually fades after birth or when ceasing the medication.
Melasma from other triggers, such as sun exposure, may last for years or even a lifetime. However, some treatments may help.
There is no single best treatment for melasma. However, any treatment plan by Dr. Ip considers your skin tone, how deeply melasma permeates your skin, and your suspected melasma triggers.
Melasma treatments look to decrease the amount of pigment in your affected areas and even out your skin tone overall. Most melasma treatments combine sun protection with medication to achieve the best results. However, we may also recommend a medical procedure for patients with stubborn melasma.
The most common medications for melasma are topical and aim to lighten the skin in the areas affected. While many over-the-counter products claim they can lighten dark spots on the skin, it may take a long time to see results, and those results may not be consistent.
Three medications are often prescribed as topical treatments for melasma: hydroquinone, tretinoin, or triple combination cream.
Hydroquinone is an organic compound formulated to treat skin concerns related to discoloration. It’s used to lighten the skin and reduce melanin production and is considered one of the most effective topical medications for melasma.
Most patients who start a course of hydroquinone see results within eight to twelve weeks of consistent use.
We may prescribe hydroquinone alone or in conjunction with another topical treatment for melasma, tretinoin.
Tretinoin is a retinoid used as a melasma treatment, but it does not lighten skin directly. Instead, tretinoin promotes cell turnover, making it highly effective when paired with a skin-lightening agent.
Tretinoin is often prescribed with a corticosteroid, such as hydrocortisone, to fade the color associated with melasma. Hydrocortisone has the added benefit of potentially reducing the likelihood of further irritation.
Triple combination cream is a highly effective treatment for melasma. It combines a corticosteroid with hydroquinone and tretinoin to reduce inflammation, lighten the skin, and increase cell turnover. Triple combination cream usually only requires eight weeks of consistent use for full results and is intended to treat moderate to severe melasma.
Melasma can be stubborn and difficult to treat. Even patients who carefully follow their treatment plan may still see melasma. In some cases, we may recommend adding a procedure to your treatment plan to improve your results. Common strategies to treat melasma include chemical peels, microneedling, and laser treatments.
A chemical peel is a procedure in which a solution is applied to the skin, removing the outermost layer. The chemical peel process leads to forming new skin without the excess pigment from melasma.
Microneedling uses a unique tool to create tiny wounds in your skin, stimulating your body’s natural healing response and promoting the production of elastin and collagen. Microneedling, when used in conjunction with topical medications, effectively treats stubborn melasma.
Laser treatments target the areas of discoloration on the skin and break up pigment while stimulating the body’s cell turnover and collagen production. Lasers are effective and popular melasma treatments.
At Vibrant Dermatology, we offer the state-of-the-art Aerolase laser, which can dramatically improve melasma on all skin types.
All treatments for melasma require consistent use of sun protection. Protecting your skin from harmful UV rays can fade melasma and keep it from returning. We recommend sunscreens that contain the following:
If the white hue these products leave on your skin tempts you to skip your sunscreen, consider purchasing a tinted sunscreen to maintain your even skin tone.
When using makeup to hide your melasma while undergoing treatments, you should first apply your topical medication, then sunscreen, and lastly, makeup.
Vibrant Dermatology offers custom, comprehensive treatment plans targeting your melasma and providing you with the best results possible. We’ll work to reveal your bright, even skin using cutting-edge treatments and thoughtful care. Book an appointment today to learn more about melasma treatments at Vibrant Dermatology.