Melasma

The main cause of melasma isn’t completely understood. It’s thought that melasma develops when something triggers your melanocytes (cells that give your skin its color), and they go into overdrive.

Possible risk factors for melasma include:

• Pregnancy: Many women develop melasma for the first time during pregnancy as their estrogen and progesterone levels increase.
• Birth control pills: Similarly, an increase in estrogen or progesterone from hormonal birth control can trigger this condition.
• Other medications: Anti-seizure medications or medications that make your skin more photosensitive (like retinoids or certain antibiotics) can worsen melasma. 
• Medium or dark skin tone: This condition develops more frequently in those with dark or olive skin.
• Genetic predisposition: You might be more likely to develop melasma if you have a family history.

A dermatologist can diagnose melasma. During your appointment, our providers will perform a close visual examination of your skin. A device like a Wood’s lamp or dermatoscope can help them see how deeply the darker pigment goes under your skin.

While there are many effective professional melasma treatments, you might be able to reduce the appearance at home. Melasma can be triggered by UVA and UVB radiation, so wearing a daily physical sunscreen with zinc oxide and titanium dioxide is an essential part of managing this condition.

Lotions containing hydroquinone can reduce the number of melanocytes and lighten the area where it’s applied. Hydroquinone creams are available in a 2% concentration over the counter, but if you need a stronger solution, it can be prescribed by a dermatologist.

Some melasma treatments carry the risk of triggering more hyperpigmentation, so it’s essential to see a highly skilled board-certified dermatologist like Dr. Stanley Skopit for the best cosmetic results. Some professional treatments for melasma include:

• Retin-A: Also called tretinoin, this prescription-strength topical retinoid promotes new cell turnover giving your skin a more even tone.
• Chemical peels: TCA or glycolic acid peels cause the top layer of skin cells to slough off and reveal a clearer complexion.
• Laser treatments: Fraxel or CO2 laser resurfacing treatments can improve the appearance of melasma by using an intense light beam to kick off cell rejuvenation.
• Intense pulsed light (IPL) therapy: IPL can target brown pigment in the skin causing it to rise to the surface and then flake away.
• Microdermabrasion: A course of treatments can reduce the appearance of melasma by exfoliating the skin and stimulating cell renewal.

Some options, like laser therapy, aren’t suitable for darker skin since they can cause pigmentation issues. However, our providers have expertise in treating all skin tones and can make the best recommendation for you.