How To Treat Melasma?

Melasma is a skin condition that affects many people. Melasma is a term that loosely translates to "black spot," and it's characterized by light brown, dark brown, and/or blue-gray areas on the skin. Flat patches or freckle-like markings are common. Face, including the cheekbones, upper lip, and forehead, as well as the forearms, are commonly affected. Melasma is known as the "pregnancy mask" because it commonly affects pregnant women. Melasma often darkens and lightens over time, with summers being worse and winters being better.

Melasma is also known as chloasma, which is a less common name. Even though this illness is innocuous, it does cause some people to feel self-conscious.


What are the different types of melasma?


Melasma is classified into three categories based on the pigmentation depth. The depth of the pigment can be determined using a Wood lamp that generates black light. The three types are as follows:

  1. Epidermal: Epidermal melasma has a dark brown color, a well-defined border, is visible under black light and responds to treatment in certain cases.

  2. Dermal: Dermal melasma has a light brown or bluish tone, a hazy border, doesn't respond well to treatment and appears the same under black light.

  3. Mixed melasma: The most common of the three, mixed melasma, has both bluish and brown patches, a mixed pattern under black light, and some therapy response.


DIAGNOSIS AND TESTS


Melasma is diagnosed by having your dermatologist or another healthcare expert inspect your skin. To see changes in the hue of your skin, they'll utilize a Wood's lamp (a black light). Because there appears to be a link between thyroid problems and melasma, you should have your thyroid tested.


Melasma can be mistaken for a variety of different skin conditions. A biopsy, in which a small sample of your skin is removed and evaluated, may be performed by your healthcare provider to distinguish between skin disorders. A biopsy is a simple, painless process that is usually done during a routine visit to your doctor's office. Melasma is frequently mistaken with the following skin conditions:

  • Actinic lichen planus and lichen planus are two different types of lichen.

  • Pigmentation is caused by drugs.

  • Hypomelanosis with guttate pigmentation.

  • Exogenous ochronosis caused by hydroquinone.

  • Lentigo is a term used to describe a condition in (age spots).

  • Hori's Nevus

  • Ota's Nevus.

  • Pigmentation after an inflammatory reaction.

If you have melasma, the biopsy findings will usually show the following:

  • Melanocytes have dendritic (branched) pigmentation.

  • Melanin in keratinocytes at the basal and suprabasal levels.

  • Melanin is found in the dermis of melanophages.

  • Solar elastosis and elongation of elastic fibers.

The Melasma Area and Severity Index can be used to determine the severity of your melasma (MASI). The test may be performed by your healthcare professional.


What is the treatment for melasma? What medications can help?


The first step in treating your melasma is to make sure it doesn't worsen. Avoid the sun, tanning beds, LED screens, irritating soaps, and birth control that contains hormones to achieve this. Wear sunscreen with iron oxides and an SPF of 30-50 every two hours, as well as a wide-brimmed hat, if you are exposed to the sun. These methods may help to keep your melasma from worsening.

Topical medicines are the second option. Topical tyrosinase inhibitors reduce the synthesis of melanin, which stops new pigment formation (the dark color). The following are some examples of tyrosinase inhibitors and other sorts of beneficial agents:


  • Azelaic acid: is used twice a day in the form of a cream, lotion, or gel. It is safe to use when pregnant.

  • Cysteamine: cream was found to be more effective than a placebo in a brief study of 50 participants.

  • Hydroquinone: This drug comes in the form of a cream or a lotion. For two to four months, it is applied directly to the melasma patches at night.

  • Methimazole: Methimazole is a thyroid medication that comes in the form of a cream or a pill. It's been shown to aid with melasma that doesn't respond to hydroquinone.

  • Tretinoin: This is a prescription for a retinoid cream. It works well, however it can cause dermatitis and should not be used while pregnant.

Can melasma be prevented?


You can't escape genetics or stop the skin issue while pregnant, unfortunately. However, you may be able to prevent the elements that aggravate melasma. No treatment can entirely prevent melasma at this moment. A skin-friendly diet with proper vitamin D levels, on the other hand, is likely to help.


In Conclusion


Melasma is a common, normal, and harmless skin condition, but it can be irritating. If you're self-conscious about your skin condition, it can affect your social life. There are therapeutic alternatives available if you don't want to "live with it." There are steps you can do to avoid this. Dermatologists are available to assist you. Inquire about them and express your concerns.


Always pay attention to your healthcare provider's instructions and stick to your treatment plan.

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