Melasma

Melasma is a common pigmentary condition that develops mostly in women, although it can occur in men as well.

Melasma is a common pigmentary condition that develops mostly in women, although it can occur in men as well. It may present as a single area of pigmentation or as multiple patches that are usually brown or grey. Melasma does not cause pain, but it can be distressing for some people. The most common distribution is a centrofacial pattern involving the forehead, cheeks, nose, upper lip and chin.

Melasma is more frequently seen in people with naturally darker skin, but it can affect any skin tone. It results from pigment-producing cells making excess melanin. Ultraviolet exposure is a major trigger, and even small amounts of sun exposure can lead to worsening in some individuals. Melasma can recur after fading if exposed to UV, so it is often more troublesome in summer. Other recognised contributors include hormones and genetics. There is evidence that people with a family history may be more likely to develop melasma. Hormonal influences can be relevant, including pregnancy, hormone therapy, thyroid or ovarian factors and some contraceptive methods.

 

Overall, the development of melasma is multifactorial and may involve UV exposure, genetic influences, pregnancy, hormone therapy, certain cosmetics or skincare, endocrine or hepatic dysfunction and selected medicines such as some anti-epileptic drugs.

 

Treatment

 Treating melasma can be challenging because some approaches may worsen pigmentation if not selected or timed appropriately. This is known as rebound pigmentation and can appear darker than the original pigmentation. An assessment with a registered health professional experienced in pigmentary conditions is important to discuss options, expected outcomes, risks and alternatives. With diligent sun protection and identification or removal of potential triggers such as pregnancy-related changes or contraceptive factors where clinically appropriate, melasma can often be managed and its appearance reduced. At Revita Skin Clinic we use a combination approach tailored to your presentation. Treatment generally requires a long-term plan rather than a short-term fix, and outcomes vary between individuals.
 

To help manage melasma, a course of chemical peels such as Jessner peels may be recommended, typically 3 to 6 sessions depending on the level and depth of pigmentation. Home skincare may include evidence-based ingredients such as glycolic or other alpha hydroxy acids, vitamin C, retinoids and daily broad-spectrum SPF 50+ sunscreen. These products are selected for their potential to support pigment control and help reduce new pigment formation. If residual pigmentation remains after peels, a medical microneedling treatment may be discussed when clinically suitable.

Risks and Recovery

All procedures carry risk and not everyone is suitable for every option. A consultation is required to confirm diagnosis and discuss a personalised plan.

  • Common temporary effects: after peels or microneedling, redness, tightness, mild swelling, flaking or dryness can occur for several days.
  • Less common risks: irritation, post-inflammatory hyperpigmentation or hypopigmentation, infection, prolonged redness, uneven pigment response or scarring in rare cases.
  • Photosensitivity: many treatments and active ingredients can increase sun sensitivity. Daily broad-spectrum SPF 50+, protective clothing and sun avoidance are essential during and after treatment.
  • Course and maintenance: multiple sessions are typically required. Recurrence is common, and maintenance with topical agents and sun protection is usually recommended.
  • Medicines and medical history: disclose all skin conditions, past reactions, current medicines and pregnancy or breastfeeding status, as these may influence suitability or timing of treatment.
  • Outcomes: results differ between individuals and cannot be guaranteed. Photographs or descriptions relate to the person treated and do not predict results for others.

The information above is general and does not replace personalised medical advice. A face to face or telehealth consultation with an appropriately qualified and registered health professional is required before any treatment can be provided.

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