Melasma treatment
(pigmentation spots)

Melasma is a common dermatological condition that occurs more often in women than in men. Although the exact mechanism of melasma production is not fully elucidated. In short, the appearance of melasma is favored by female sex hormones and ultraviolet radiation that stimulates melanin production. This is the pigment that gives color to the skin, hair and eyes. Excess melanin is deposited on the skin, leading to the appearance of characteristic lesions.

A special form of melasma is chloasma or "pregnancy mask". It occurs secondary to the hormonal changes specific to pregnancy and affects more than half of pregnant women. Fortunately, in most cases, it goes away in the first months after birth.

• Genetic predisposition (if members of your family have had melasma, you may have a higher risk of developing the condition)
• Dark skin phototype (brunette people with brown eyes and who tan very easily)
• Exposure to the sun or other sources of ultraviolet radiation
• Administration of oral contraceptives
• Hormone replacement therapy
• Thyroid disorders
• Administration of photosensitizing drugs
• Cosmetic treatments and dermato-cosmetic products 

The causes of melasma still remain unknown, but several factors are involved in the etiology of this condition: prolonged exposure to the sun, genetic factors, certain drugs with photosensitizing action, hormonal changes (pregnancy, use of contraceptives or certain conditions of the thyroid gland or ovaries), as well as the use of certain photosensitizing cosmetics (perfumes, creams).

Melasma is manifested by the appearance of brown-brown hyperpigmented spots with irregular edges, symmetrically located on the face. Lesions can meet, taking on a network appearance.

Depending on the affected areas, we distinguish several types of melasma:

• Centrofacial (60% of cases) – affects the forehead, nose, upper lip and chin. It is the most common form of melasma.
• Malaria (25% of cases) – affects the area of the cheeks and nose
• Mandibular (15% of cases) – affects the mandibular line.

The effectiveness of these treatments can vary from person to person, and melasma has a high risk of recurrence, even after successful treatment. Sun exposure and hormonal changes can cause melasma to recur. For this reason, long-term management of melasma often involves continued use of sunscreens and avoiding sun exposure as much as possible. In addition, patients may require maintenance treatments, such as continued use of topical treatments.

1. Sun avoidance and sun protection: This is the most important part of melasma treatment. Sun protection against UVA and UVB rays can help prevent melasma from getting worse.
2. Topical Treatments: These include creams, lotions, and gels that contain ingredients that inhibit melanin production. These ingredients may include hydroquinone, azelaic acid, kojic acid, retinoids, corticosteroids, vitamin C, niacinamide, and others.
3. Chemical Peel: A chemical peel can help remove the top layer of skin, reducing the appearance of melasma patches. Glycolic acid, salicylic acid, trichloroacetic acid, and other acids can be used in chemical peels.
4. Laser and Intense Pulsed Light (IPL) therapy: These treatments can be used to remove or diminish melasma spots, although results may vary. Some people may see significant improvements, while others may see little change or even a worsening of their melasma.
5. Microdermabrasion and Dermabrasion: These skin removal procedures can be used to treat melasma in some cases.