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Melasma 101

Melasma is a particularly persistent type of hyperpigmentation, characterised by uneven skin tone and often worsened by sun exposure or hormonal changes. This guide explains more about the condition, its causes and how to treat and manage it. 

What is melasma?

Melasma is the most common cause of hyperpigmentation and occurs when the melanin-producing cells in our skin become overstimulated. It’s most easily characterised by brown or greyish patches or large spots of mottled pigmentation on the skin’s surface. 

A helpful identifier of melasma is that the pigmentary changes are usually symmetrical.

It’s typically found on the face of women and is most easily identified by flat brown blotches that mainly affect the upper lip (you may have heard of ‘melasma moustache’ or ‘melasma lip’ before), cheeks, nose, forehead, and chin. Also, a helpful identifier of melasma is that the pigmentary changes are usually symmetrical.

There can be lots of reasons why it appears, from hormonal changes during pregnancy to overexposure to the sun. Although more often seen in women with darker skin tones, melasma can affect anyone, with most cases first occurring in our 30s or 40s. Environmental factors can play a role in melasma but it also has a strong genetic predisposition, with at least one-third of people reporting family members affected.

What causes melasma?

We know that prolonged exposure to the sun makes the appearance of melasma worse. You may well notice that your melasma becomes more visible in the summer.

Consultation Dermatologist, Dr Ben Esdaile explains, “This time of year always tends to be a busy time for melasma as sun exposure over the summer months tends to flare up the condition. Protecting the skin from both ultraviolet and visible light is essential and so the correct choice of sunscreen is a vital part of treatment.”

Hormonal changes in women can also lead to the sudden appearance of melasma with up to 25 per cent of women taking the combined oral contraceptive pill and half of all pregnant women developing melasma – which is why melasma is often called the ‘mask of pregnancy’. While melasma is less common in men, they are still identified in 10 percent of cases. This means that other factors besides female hormones and UV light are still at play. Because of this, the exact root cause of the skin condition remains unknown.

“This time of year always tends to be a busy time for melasma as sun exposure over the summer months tends to flare up the condition.” Dr Ben Esdaile

How does Skin + Me treat melasma? 

If you’re diagnosed with melasma by your Prescriber, you’ll be prescribed a personalised treatment cream containing a combination of powerful, evidence-based ingredients proven to be effective in treating melasma and maintaining remission. 

Skin + Me recommends a combination of hydroquinone, tretinoin (a topical retinoid) and hydrocortisone (a topical steroid) as the gold standard to treat melasma. After that, your melasma cream formulation will change and adapt to include the ingredients of tretinoin, azelaic acid and niacinamide

Due to each solution being formulated in bespoke quantities and prescribed long-term to prevent future patches from appearing, this staggered approach is the tried and tested most effective way to initially treat melasma and prevent it from recurring. 

What’s the best skincare routine for melasma?

While a personalised melasma treatment is a great starting point to get your new skincare journey rolling, it’s also crucial to take sun care seriously. Regularly apply high-factor sunscreen (SPF 50+ with UVA and UVB protection) to get the best results from your treatment. Remember, that unprotected exposure to the sun can undo months of treatment.

Alongside regular sun protection and your personalised melasma treatment, a gentle cleanser and moisturiser are all you need to optimise your routine. 

If you do want to add an extra serum or treatment to your routine, Consultant Dermatologist, Dr Malvina Cunningham recommends “over-the-counter ingredients such as vitamin c, kojic acid, mandelic acid or arbutin for maintenance.” 

Remember, a single moment of exposure to the sun can undo months of treatment.

How long does it take to treat melasma?

You’re unique and so is your skin, which means there’s no one-size-fits-all answer here. The good news is that by using our custom-made treatment of hydroquinone, tretinoin and hydrocortisone solution every evening, you could expect to see patches of pigmentation improve within two months. 

Then, we’ll focus on maintaining the results. Your treatment will evolve with a formulation that’s designed to sustain your progress and prevent any future patches from appearing. 

We’re always here to guide you through your treatment, whether you need questions answered, need advice or to change your formulation. We’ll check in with you to see how your skin is responding, and whether you need a change in your treatment plan.

The Skin + Me community is full of stories from people who have finally managed to take effective control of melasma – rather than having it control their lives. We love to see your personal progress on Facebook and Instagram, don’t forget to share your journeys too.

Managing and reversing melasma is possible, it just takes a bit of extra care, your personalised Daily Doser and perseverance to make it happen. Take it from Skin + Me Subscriber Frances, and read all about her melasma journey. Even skin tone, here we come.

Medical facts checked by Head of Medical, Dr Jason Thomson.

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