Does dark skin discoloration worry you?

Some are there at birth and some are born much later in life, but any sort of dark mark on the skin can embarrass even the most thick-skinned among us. Melasma is one of the most common skin disorders in women. Also called chloasma, Melasma is a dark skin discoloration found on sun-exposed areas of the face. A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip. It is most often symmetrical (matching on both sides of the face). Melasma has also been referred to as the “mask of pregnancy” because it often develops during pregnancy.

Melasma doesn't cause any other symptoms besides skin discoloration but may be of great cosmetic concern. The pigmentation of melasma may be deposited in one or more layers of the skin. The pigment may be confined to the surface layer of skin, the epidermis. Alternatively, it may be present solely in the inner layer of skin, the dermis. Generally, it is present to a greater or lesser degree in both outer layers of skin. The presence of pigment both within the skin’s surface layer as well as deeper within the skin has important implications for Melasma treatment.

Causes of Melasma
Although melasma can affect anyone, persons who have inherited baseline skin color in the very light olive to very dark olive range are particularly susceptible. It occurs most frequently among women who take birth control pills, those who are pregnant, and those who take hormone replacement therapy during menopause. Because of Melasma’s relation to pregnancy and oral contraceptives, it is thought that hormone called estrogen contributes to its development in predisposed persons. Estrogen is not essential to the development of melasma, however, as men may also be affected.

Sun exposure is also a strong risk factor for melasma. Both ultraviolet A (UVA) and ultraviolet B (UVB) are believed to contribute to the formation of melasma in predisposed persons. Besides, heredity can also play a role.

However, melasma generally fades after a woman gives birth or stops taking birth control pills, but it may never go completely.

Treatment of Melasma
Regardless of the methods used to treat melasma, results vary greatly. Much of this variation is due to differences in where the melasma related pigment is located within the skin in different people. Hydroquinone creams, available both over-the-counter and in prescription-strength formulations, can help fade existing melasma spots.

Doctors usually recommend prescription hydroquinone products when less-concentrated over-the-counter formulations aren’t effective. Hydroquinone is available by prescription in concentrations of 3 % (brand name Melanex) and 4 % (Eldoquin-Forte, Eldopaque-Forte, Solaquin Forte). It can take six to 12 weeks of treatment before you notice some significant improvement.

Melasma spots often reappear when you stop using hydroquinone products. Hydroquinone can make the skin very sensitive to the sun, so you should use it in combination with a sunscreen.

Tretinoin (Retin-A, Renova) is sometimes used alone or in combination with hydroquinone to treat melasma. It increases the turnover of skin cells, a process that helps reduce excess pigmentation. Tretinoin lightens melasma spots slowly over several months. The spots usually reappear after treatment stops.

Chemical peels or laser removal are other treatment options. These methods lighten dark areas immediately. They can reduce melasma in the long term for many women, but the spots may reappear for some.

If birth control pills are causing your melasma, consider switching to a birth control pill with a lower level of estrogen.

Home Remedy for Melasma
The best treatment for melasma may be a combination of topical creams and oral supplements. A new treatment for melasma could include grape seed extract. Another option is topical arbutin.

Prevention from Melasma
Melasma is a challenge to successfully treat and needs great discipline with regards to continuous sun protection. Daily sunscreen use not only helps prevent melasma, but also reduces the risk for wrinkles and skin cancer.Fortunately, most people can obtain satisfying results with a combination of sunscreen/avoidance and appropriate topical therapy.