Melasma Treatment · Dermatologist · Cosmetic, Laser Dermatology NYC

Melasma Treatment

If 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 develop 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 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.

Melasma Causes

Melasma is believed to be associated with hormone spikes, such as women who are pregnant, perimenopausal, or using medicines that affect hormones, such as birth control medications or hormone replacement therapy. 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. Exposure to heat has been shown to exacerbate melasma as well.

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 deeper layers of the skin. Epidermal melasma is distinguished by excessive melanin in the more superficial layers of the skin. 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 a darker skin color.

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.

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.

Your NYC dermatologist can recommend a variety of melasma treatment options. Most dermatologists will start with topical treatments, such as:

• Hydroquinone: The most common treatment of melasma, hydroquinone (HQ) works by lightening the skin color. It’s an over-the-counter product, but if your condition is more severe, you can get a prescription-level version of hydroquinone.
• Corticosteroids: Topical corticosteroid creams can help lighten melasma by decreasing pigment production in the skin.
• Retinoids: Drugs like tretinoin promote the lightening of the skin by microscopically sloughing off stained layers of skin.
• Kojic, glycolic, or azelaic acid: The creams that contain these ingredients also provide positive results in lightening the effect of melasma on your skin.

If you’ve tried all of these treatments and none have been effective at diminishing your melasma, then your top dermatologist in NYC may recommend:

• Microdermabrasion: This technique involves an instrument that exfoliates your face, removing the top layer of stained skin cells.
• Laser or Intense pulsed light: Certain wavelengths of laser and IPL can specifically target pigment in the skin and break it up, allowing for the body to get rid of it.
• Chemical peel: A chemical peel uses an acid solution that causes the stained top layers of skin to separate from your face and allows for easy peeling to reveal the fresh layers beneath.

Side Effects of Melasma Treatment

Talk to your NY dermatologist about all the possible side effects of 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 to years of continuous use is a condition called exogenous ochronosis, which is a darkening of the skin. This is why we recommend taking a break for a month after every 3 months of HQ use. Ochronosis is rare in the United States but is more common in African countries where HQ 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 darkening of the skin, immediately stop using the HQ cream.

Important Reminder: This information is only intended to provide guidance, not 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.