MELASMA

OVERVIEW

Melasma is a chronic pigmentary skin condition characterized by symmetrical brown or gray-brown patches that most commonly affect the face, including the cheeks, forehead, upper lip, and chin. It is more frequently seen in women and individuals with darker skin types.

Melasma is not dangerous or contagious, but it can be persistent and cosmetically distressing. While the condition cannot be cured, pigmentation can often be managed and lightened with appropriate medical care, strict sun protection, and long-term maintenance.

COMMON FEATURES OF MELASMA

Melasma may present with one or more of the following features:

Brown, tan, or grayish patches with irregular borders
Symmetrical involvement of the face
Gradual darkening with sun or heat exposure
Worsening during pregnancy or hormonal changes

Unlike freckles or isolated sun spots, melasma is a chronic condition with a tendency to recur over time.

WHAT CAUSES MELASMA?

Melasma develops due to increased melanin production by pigment-producing cells (melanocytes). Multiple factors may contribute, including:

Ultraviolet (UV) and visible light exposure
Heat exposure
Hormonal influences, such as pregnancy or hormone therapy
Genetic predisposition
Certain medications or photosensitizing agents

Because melasma may involve both superficial and deeper pigment, treatment can be challenging and requires individualized management.

MEDICAL MANAGEMENT OF MELASMA

Melasma treatment follows a stepwise, conservative-first approach. Initial management focuses on stabilizing pigment activity and preventing further darkening.

Medical management may include:

Strict daily sun protection
Prescription topical agents to suppress melanin production
Gentle skin care to protect the skin barrier
Identification and avoidance of hormonal or environmental triggers

Laser therapy is not considered first-line treatment for melasma, particularly when pigmentation is active or unstable.

Successful management depends not only on treatment, but also on addressing ongoing stimulating factors. Continued exposure to ultraviolet or visible light, heat, or hormonal influences may significantly limit treatment response and increase the risk of recurrence.

ROLE OF PROCEDURAL TREATMENTS IN MELASMA

Once melasma is medically stabilized and pigment activity is controlled, procedural treatments may be considered selectively for residual discoloration.

Procedures are adjunctive, not curative, and must be chosen carefully due to the risk of rebound pigmentation or post-inflammatory hyperpigmentation. Without control of contributing factors, procedural treatments may provide limited or temporary improvement.

Not all patients are candidates for procedural treatment.

LASER AND ENERGY-BASED TREATMENTS FOR MELASMA

Laser and energy-based treatments may be used cautiously in selected patients as part of a comprehensive management plan. Their role is limited and focused on treating residual pigment while minimizing inflammation.

Low-fluence pigment-targeting lasers or non-ablative fractional devices may be considered in carefully selected cases. Treatment parameters must be individualized based on skin type, pigment depth, and disease stability.

Aggressive laser treatment is generally not appropriate for melasma and may worsen pigmentation if improperly selected or timed.

LONG-TERM MANAGEMENT

Melasma is a chronic condition with periods of improvement and recurrence. Improvement is often gradual and requires ongoing maintenance.

With appropriate medical management, sun protection, and selective use of procedural treatments when indicated, many patients experience meaningful improvement in pigmentation over time.

Discuss Melasma Evaluation and Management

Melasma requires individualized evaluation and long-term management planning.

📞 Call (847) 518-9999 to schedule a dermatology evaluation.

Medical Disclaimer
This information is provided for educational purposes only and does not replace individualized medical evaluation. Treatment recommendations depend on clinical findings, diagnostic requirements, and patient-specific factors. Outcomes may vary, and no specific medical result can be guaranteed.

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