Melasma

Skin lesion whitening

Melasma treatment

Melasma, also known as chloasma or the mask of pregnancy, is a skin condition that consists of the appearance of dark brownish spots (hyperpigmentation) located and distributed mainly in areas exposed to the sun (face).

It presents as irregular spots of brown, gray, or even bluish color, asymptomatic, which are usually bilateral and symmetrical, most often affecting the face, neck, and more rarely the forearms. It is fundamentally an aesthetic problem.

The cause is unknown, but there are multiple factors that may be involved in its development:

  • Genetic predisposition
  • Exposure to ultraviolet and solar light
  • Hormonal factors: contraceptives (estrogen levels), pregnancy (progesterone levels)
  • Possible cosmetic factors, causing some irritative or allergic process
  • Drugs

In many cases, several factors may coincide, which cause the process to be maintained. It may disappear during the winter and reappear in summer after sun exposure.

In some cases, its onset coincides with the start of contraceptive treatment or during pregnancy. In 50% of women, no clear trigger is demonstrated (except for the sun).

It is an almost exclusive process of middle-aged women (90%). Rarely persists after menopause. It mainly affects women of Hispanic and Asian origin. In dark-skinned races (Hindus), it can be observed from childhood.

On the face (the area where it is most frequently observed) the patterns are defined:

  • ​Centrofacial (the most frequent – approximately 66%) – forehead, nose, chin, supralabial area, and the central part of the cheeks
  • Malar (approx. 20%) – cheeks and nose
  • Mandibular (approximately 15%) – mandibular area

    It is variable, although it usually lasts for years, with increases in coloration during the months of sun exposure (summer). The treatments used attempt to reduce or alleviate the lesions
    Up

The treatment is based on producing a whitening of the lesions, although there is a significant tendency for recurrence. They are usually long-term treatments.

It is based on:

A) Prevention:

  • Avoid as much as possible the direct incidence of the sun or light systems that induce an increase in lesions
  • High protection sunscreens (greater than SPF 50), both in summer and winter

B) Treatment to achieve whitening or elimination of lesions:

  • Drugs: That produce an inhibition of the formation of melanin by various mechanisms, generally topical, that combine melanogenesis-inhibiting substances and exfoliating substances.
  • Peeling: The above products are combined, adding keratolytic substances (salicylic and glycolic acid, among others)
    All these treatments must be combined with preventive and whitening treatments.
Melasma
Result

Immediate

Application

15 minutes

Duration

Up to 12 months

Anesthesia

Not required

Melasma