Melasma (Brown Spots) Description, Diagnosis and Treatment
What is melasma?
Melasma is a skin condition presenting as brown patches on the face of adults. Both sides of the face are usually affected. The most common sites of involvement are the cheeks, bridge of the nose, forehead, jawline and upper lip. Melasma typically occurs in women. Only 10 percent of those affected are men. Dark-skinned races, particularly Hispanic, Asian, Indian, people from the Middle East and Northern Africa tend to be affected by melasma more than others.
The precise cause of melasma is unknown. People with a family history of melasma are more likely to develop it themselves. It is commonly associated with pregnancy and called chloasma, or the “mask of pregnancy.” Birth control pills may also play a role. Sun exposure contributes to and worsens the problem. Incidental exposure to the sun, even if it is only for a few minutes a day, is the main reason for recurrences. Melasma is not associated with any internal disease or organ malfunction.
Melasma treatment in the Dallas area
While there is no cure, there are many melasma treatments that have been developed. Sunscreens are essential in the treatment of melasma. They should be broad spectrum, protecting against both UVA and UVB rays from the sun. An SPF 30 or higher should be selected. In addition, physical sun blocks, which contain either zinc oxide or titanium dioxide, are used to block and reflect the ultraviolet radiation and visible light. This is important because chemical sunscreens (all active ingredients other than zinc oxide or titanium dioxide) typically work by absorbing light and converting it to heat, which can actually worsen melasma. Thus, chemical sunscreens should not be used without physical sunscreens. Sunscreens should be worn daily, whether or not it is sunny outside, or if you are outdoors or indoors. A significant amount of ultraviolet rays are received while walking down the street, driving in cars and sitting next to windows.
A variety of lightening creams are available for the treatment of melasma. These creams lighten the skin by inhibiting the ability of the melanocytes to decrease production of pigment. Hydroquinone is considered the gold standard for melasma treatment and is most effective and safe when used at the 4 percent strength twice daily. Certain skin care systems contain multiple steps of hydroquinone plus other prescription-strength agents that help to penetrate the hydroquinone even deeper into the skin where some of the pigment lies. Typically, it takes about three months to substantially improve melasma. Other medications that have been found to help are azelaic acid and kojic acid. Remember to always use a sunscreen in addition to skin lightening agents.
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Chemical peels, microdermabrasion and laser resurfacing may help, but results have not been consistent among individuals. These procedures have the potential of causing irritation, which can sometimes worsen the problem. Generally, they should only be used by a dermatologist in conjunction with a proper regimen of bleaching creams and prescriptions creams tailored to your skin type. Additionally, it is important to remember that it is clinically not indicated to perform any laser or light treatments for the treatment of melasma during the summer months between May and September.
Management of melasma requires a comprehensive and professional approach. Avoidance of sun and irritants, use of sunscreens, application of depigmenting agents and close supervision can lead to a successful outcome. Dr. Turner prizes outstanding patient care and makes every effort to listen to her patients’ concerns, then help them to choose an appropriate therapy. Patients describe consultations with her as comfortable, informative and respectful. To schedule a visit with Dr. Turner to discuss melasma and its related therapeutic treatment options, you can book an appointment online or call the office at (214) 373-7546.
How much does melasma treatment cost?
The treatment cost will depend on which specific treatment is chosen, and for how long the sessions last.