Advice Clinic

Melasma Explained

What does melasma look like?

Brown or grey-ish patches of skin. It usually appears on the forehead, cheeks, bridge of the nose, upper lip, and chin.

The causes of melasma

Skin contains cells called melanocytes that are responsible for the production of melanin, the brown skin colouring pigment. Melanocytes overproduce melanin, which then gets transferred to the nearby skin cells. This condition is known as epidermal melasma and can be treated with topical products.

Dermal melasma, on the other hand, occurs in the deeper layers of skin. Because of inflammation, the basal cell layer is disrupted and again discolouration appears. Dermal melasma is more difficult to treat than epidermal melasma.

Who can be affected by melasma?

Melasma can affect both men and women, however, it more commonly affects women (90% of sufferers are women). Furthermore, studies have shown that people who have a family history of melasma are also prone to it. It also affects people who tan easily and people with darker skin tones.

Common triggers for melasma

Sun exposure – UV light stimulates melanocytes, which explains why melasma is more prominent during the summer months or returns at that time.
Birth control and/or pregnancy – a change in the hormones can also trigger melasma. Hormone replacement therapy, change in birth control pills and implants can all make melasma return. It can also occur during pregnancy when chloasma (or so-called the mask of pregnancy) can appear. Usually, it will go away a few months after the birth.
Thyroid dysfunction – a small percentage of people who suffer from Hypothyroidism also develop melasma.

How is melasma treated?

In consultation with your dermatologist, you can explore a number of options. Do bear in mind that the progress can be slow. Different lasers such as IPL (Intense Pulsed Light) and fractional lasers have been shown to be suitable options to treat melasma.

One of the more popular treatments was/is Hydroquinone at concentrations between 2 and 4%. However, it is a highly irritating cytotoxic ingredient that can cause stinging, redness and contact dermatitis. It is banned in the EU, Australia, and Japan.
Kojic acid is a popular ingredient which is again problematic due to sensitising issues.

A combination of products with Mandelic acid, retinol and vitamin C to:

  • gently exfoliate (to remove dead skin cells and reduce the number of over-pigmented cells from the surface of the skin),
  • increase the cell turnover (to encourage new skin cells to form and to speed up the shedding of over-pigmented cells in the deeper levels of epidermis),
  • for anti-inflammatory repair (to stop excess pigment from being released).

That said – all of the effort will be for nothing if you do not wear a broad spectrum SPF on daily basis. During the summer months, don’t forget a wide-brimmed hat and sunglasses.

Ishtar products to try:

Ultralase 10 serum (suitable for most skin types) – leave-on treatment serum with 10% Mandelic acid used 3 times per week.

Bioactive 1% retinol serum (for sensitive skin types) or Bioactive 2.5% retinol cream (suitable for all skin types who have tried retinol products before).

Brighten-Up Pigment Correcting fluid – with Chromabright (Dimethylmethoxy Chromanyl Palmitate), a powerful ingredient that has been proven to treat hyperpigmentation, and 4% Niacinamide.

EFA ProRepair oil with 5% Ascorbyl Teraisopalmitate, a stable vitamin C ester, and 2% Tocoretinate-10, that potentiates the vitamin C.

Do you suffer from melasma? What are some of the products and/or treatments that you have tried that have proven to be effective?

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Roberta Striga

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