Melasma

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What it is

Melasma consists of patchy, irregular brown or grayish-brown facial discoloration of areas in areas of the face exposed to UV radiation, and it most often affects women.

What causes it

There are multiple potential contributing factors to melasma, including:

• Genetic predisposition;

• Pregnancy (Melasma is sometimes used interchangeably with the term “chloasma,” which is a hyperpigmentation that often results from pregnancy or changes in the uterine and ovarian hormones.);

• Use of oral contraceptives;

• Endocrine dysfunction or hormone treatments; and

• Exposure to UV light.

What it looks like

Melasma is generally categorized into one of three types:  epidermal, dermal and mixed, and there are three recognized clinical patterns for melasma:  centrofacial, malar and mandibular. The centrofacial is the most common pattern and involves the cheeks, forehead, upper lip, nose and chin.

How to treat it

Treatment of melasma often involves prevention or reduction in the severity of recurrence.  However, several treatments have been identified as improving the defect. The principles of therapy include protection from UV light, inhibition of melanocyte activity and the removal of melanin granules. These therapies include:

• Discontinuation of oral contraceptives, phototoxic drugs and the use of broad-spectrum sunscreens;

• Use of melanogenesis inhibitors, such as hydroquinone, tretinoin, azelaic acid, arbutin, kojic acid, phenylethyl resorcinol, lactic acid, L-ascorbic acid, undecyloylphenylalanine, and mulberry or licorice extracts;

• Non-selective suppression of melanogenesis-using corticosteroids;

• Inhibition of ROS using azelaic acid;

• Removal of melanin using chemical peels; and

• Thermal damage using laser treatments.

Source:  Gupta, A.K., Gover, M. Nouri, K. and Taylor, S.  “The treatment of melisma:  A review of clinical trials.”  Journal of the American Academy of Dermatology.  December 2006.  Volume 55, Number 6, pp. 1048-65.

PCA SKIN® product options for treatment include Pigment Gel®, Brightening Therapy with TrueTone, Pigment Bar, Intensive Clarity Treatment: 0.5% pure retinol night, A&C Synergy Serum and Perfecting Protection SPF 30.

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