Hyperpigmentation is a term used to describe skin with altered colour due to environmental stress factors, acne scars, or inflammation from eczema flare-ups. While melasma is a form of hyperpigmentation, it is caused by a variety of internal factors.
It is most commonly found in women, especially during pregnancy, due to the hormonal changes. It typically appears on the forehead, the upper lip, and the chin, and it worsens with sun exposure. This condition is also known as the “mask of pregnancy.” Similarly to the general facial hyperpigmentation, melasma appears as dark spots and becomes more pronounced when exposed to sunlight.
Contents
Hyperpigmentation can refer to any darkening of the skin
Spots from persistent acne scars, freckles that have developed into full-blown sunspots due to excessive exposure, or discolouration caused by conditions such as eczema or psoriasis are usually diagnosed as hyperpigmentations.
This is because the acne, the sunlight, the skin rashes, and the other similar conditions have the potential to stimulate the melanocytes (the cells responsible for the pigment in the skin) to produce excessive pigment in the more superficial layers of the dermis.
The deeper the pigment, the more stubborn it is to treat. The skin that has been constantly exposed to the harmful UV rays without adequate protection will be more difficult to treat than the leftover dark spots from pimples, which you did not take care to protect from the sun. If you notice a discolouration of the skin that you did not have before, it can be assumed that this is hyperpigmentation. To be sure, you should consult your dermatologist.
What is melasma?
Melasma is a form of hyperpigmentation that is more commonly observed in women (especially those with darker skin tones) and is believed to be triggered by ultraviolet exposure, as well as by hormonal influences. It differs from the traditional hyperpigmentations and it is more difficult to treat.
The hormonal influence during pregnancy plays an important role, as does the use of oral contraceptives and other hormonal therapies. You can identify melasma based on its shape – it manifests as symmetrical hyperpigmented spots on the face, typically on the cheeks, nose, forehead, chin, and upper lip. Although less commonly, the melasma can also appear on other parts of the body, particularly those exposed to the sun (such as the neck and the forearms). Many patients report that their melasma worsens in the summer and improves in the winter. Several factors can contribute to the appearance of melasma, including the visible light and the heat. The dermatologists usually recommend the use of makeup that contains iron oxide to block the visible light. Unfortunately, the avoidance of the infrared heat proves to be more difficult, as it is generated just by being in a hot environment such as a sauna, a kitchen, or even the gym.
Treatment of melasma
Melasma is challenging to treat. Unlike the traditional hyperpigmentations, which respond to various over-the-counter products containing some lightening agents like vitamin C, niacinamide, hydroquinone, and azelaic acid, melasma does not enjoy the same level of success.
Often, what works for one patient does not work for another, making it difficult to determine the most effective treatment for melasma.
The top dermatologists recommend a combination of sunscreen, lightening ingredients, and laser treatments (the Alma-Q laser therapy is particularly effective). For the treatment of hyperpigmentation, they prescribe a combination of medications, chemical peelings, PRP therapy, lightening mesotherapies, microneedling, and DYE VL technology (Harmony Laser XL Pro).
The treatment depends on the severity of the melasma, the therapy is individualised, and each treatment plan is unique and prescribed by a dermatologist.
Neither melasma, nor hyperpigmentation can be avoided or corrected without the use of a proper sunscreen
The diligent use of a sunscreen is especially important when it comes to the prevention of any sun-induced conditions. Although triggered by hormonal factors, having melasma does not mean you should forgo your SPF, as the UV rays exacerbate the condition.
The dermatologists recommend the application of an SPF 30 or higher every two hours, even if you are indoors but near a window. You can also use a moisturiser that contains an SPF.
All in all, understanding the distinction between melasma and the other forms of hyperpigmentation is crucial for their effective treatment and management.
For those struggling with melasma, a multi-faceted approach is often required, combining a diligent sun protection with targeted treatments such as laser therapy and prescription lightening agents. It is essential to remember that the consistency in sun protection is key to the prevention of the worsening of both melasma and hyperpigmentation, as the UV exposure remains a primary factor in their development and persistence.
Consulting a dermatologist to tailor a treatment plan to your specific condition is always recommended. Whether you are dealing with melasma, or general hyperpigmentation, the personalised care can make a significant difference in the achievement of a clearer and more even-toned skin. Ultimately, with the right approach and a commitment to your sun protection, you can effectively manage these skin concerns and improve your overall skin health.