Melasma Treatment

Melasma Treatment · Dermatologist NYCIf you’re pregnant, on birth control pills or undergoing any treatment that may spike your hormone levels, you may have noticed a gray or brownish skin discoloration on your face. If so, you may have a condition called melasma. Men can develop melasma too, but typically women between the ages of 20 and 80 contract it. It’s no coincidence that 90 percent of these women are either pregnant or on birth control pills.

While melasma isn’t a contagious or serious condition, it may not go away on its own. See your New York dermatologist to receive a thorough examination and treatment. You may not even have melasma. A variety of skin conditions are common, and some even have similar symptoms. Only a good dermatologist can diagnose what’s troubling you.

If you have a skin condition that’s causing pain, it’s unlikely to be melasma, as melasma itself isn’t painful. You may feel the tenderness or soreness that’s associated with sunburn if your melasma is linked to excessive exposure to the sun’s UV rays. Melasma can also become inflamed, which may cause irritation.

All symptoms, potential procedural/surgical options should always be discussed with your physician after a thorough consultation and examination  for an accurate diagnosis and treatment plan.

Melasma Causes

There’s actually no known cause of melasma, but it’s believed to be associated with hormone spikes in women who are pregnant or using medicines that effect hormones, such as birth control medications. Your NYC dermatologist can tell you what may be causing the condition in your particular circumstance. Ultraviolet (UV) rays from excessive exposure to sunlight have been proven to aggravate melasma, as it darkens your skin’s pigmentation.

Melasma is a symmetrical condition that can appear on your cheeks, forehead, chin and above your lips. So it occurs in identical patterns on both the left and right sides of your face. Melasma can also appear on other parts of the body such as your arms and shoulders, but it’s most common on your face. Dermatologists call this darkening of skin hyperpigmentation.

The Four Types of Melasma

Melasma pigment discoloration is broken down into four groups:

  1. Dermal
  2. Epidermal
  3. Mixed
  4. An unnamed type that appears in people with darker skin

Dermal melasma contains melanophages — cells that consume melanin — throughout the skin. Epidermal melasma is distinguished by excessive melanin in the top skin layers. The third type of melasma is a combination of the dermal and epidermal types. The last type is an excess of melanocytes in people who have darker skin color.

How Melasma Is Diagnosed

The best way your New York dermatologist diagnoses melasma is by recognizing the discoloration — the gray or brown patches on your face — and identifying them as melasma. Dermatologists in Manhattan are specialists, so your primary doctor may refer you to a dermatologist if necessary to diagnose your condition.

To reach a diagnosis, a good dermatologist asks questions about your general healthcare as well as questions about your genetics to see if your parents had any skin issues that they may have passed along to you genetically. The dermatologist conducts a visual examination that may include the use of a UV light called a Wood’s light that penetrates deep into the layers of skin. If the dermatologist is still unsure of the condition, a biopsy is taken. This is a skin sample that’s removed and sent to a laboratory for testing to determine your exact condition.

Treatment for Melasma

The first thing your New York City dermatologist will tell you if you have melasma is to protect yourself from harmful sun rays. If you are pregnant or taking medicines that affect hormones, you may have to avoid the sun as much as possible. Exposure to the sun can exacerbate the condition, even if it wasn’t the primary cause.

At first, your doctor may recommend over-the-counter creams, like Esoterica and Porcelana, to treat your melasma. The active ingredient in these products is hydroquinone (HQ). Your dermatologist may prescribe higher strengths of HQ in creams as needed. Products like Tri-Luma, Obagi and NeoCutis Blanche can help lighten your skin back to normal.

Typically, you apply these creams to the discolored patches of skin twice per day. Sunscreen can be applied over HQ cream each morning. Of the four types of melasma, the epidermal type responds best to HQ cream treatment because the pigment in epidermal melasma is near the top layer of the skin’s surface.

Your melasma may clear up on its own without treatment. This may happen over the course of weeks or months. Sometimes, it clears with the use of sunscreen and from avoiding direct sunlight. Many women who use birth control pills find that their melasma clears up when they discontinue use. Women who are pregnant and have melasma report that it cleared up right after their pregnancy.

Side Effects of Melasma

Talk to your NY dermatologist about all the possible side effects with any skin issue. Melasma treatments may produce skin irritation as a side effect. This irritation is temporary, so you should continue using the HQ cream unless the irritation is severe.

If you’ve been prescribed a stronger HQ cream, a possible side effect that may occur over several months is a condition called exogenous ochronosis, which is a darkening of the skin. Using HQ concentrations over four percent may result in permanent skin discoloration. This side effect is rare in the United States, but is more common in African countries where concentrations of ten to 20 percent are used to treat melasma. In spite of these long-term side effects, HQ creams are still the most effective treatment and the most widely marketed worldwide. If you develop ochronosis, immediately stop using the HQ cream.

Prevention of Melasma

The best way to avoid contracting melasma is to limit your time in direct sunlight. If you can’t avoid being in the sun for extended times, make sure you follow these preventative suggestions:

  • Use a potent sun block, such as one with titanium dioxide or zinc oxide
  • Throw shade on your melasma with a wide-brimmed hat
  • Use a sunscreen with an SPF of at least 30, which also protects against UVA and UVB radiation

As there is no known cause of melasma, talk to your best rated New York City dermatologist about possible triggers that you may not be aware of. In addition to sunlight and birth control pills, triggers like other medications that stimulate hormones may be causing your condition. Follow your skin doctor’s recommendations and use the medicines as directed.

All symptoms, potential procedural/surgical options should always be discussed with your physician after a thorough consultation and examination  for an accurate diagnosis and treatment plan.

Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult dermatologist NYC about your specific condition. Only a trained, experienced board certified dermatology doctor or pediatric dermatologist can determine an accurate diagnosis and proper treatment.

Do you have any questions about Melasma Treatment? Would like to schedule an appointment with an internationally recognized, best rated New York City dermatologist, Dr. James Taft of Manhattan Dermatology Specialists, please contact our Midtown NYC office for consultation with cosmetic and laser dermatologist.

Manhattan Dermatology Specialists
Dr. James Taft (Laser Cosmetic Dermatology of NY)

51 East 25th Street, Ste 411
New York, NY 10010

(Between Madison Ave & Park Ave)
(212) 889-2402

The information on this website is to provide general guidance. In no way does any of the information provided reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a best in class dermatologist regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today and schedule a consultation.