What is Melasma defined as?


Melasma is a common skin condition characterized by the development of brown or grey-brown patches on the face.


What causes Melasma?

The exact cause of melasma is not fully understood, but it is thought to be related to the overproduction of melanin, the pigment that gives colour to our skin.


Hormone imbalances are known to be a common trigger for the development of melasma. Specifically, changes in the levels of oestrogen and progesterone can stimulate the production of melanin in the skin, leading to the formation of dark patches.


While hormone imbalances can play a role in the development of melasma, other factors such as sun exposure, genetics, and certain medications can also contribute to the condition. It’s important to talk to your GP, dermatologist or Medical Aesthetics Professional who specialises in skin to get a proper diagnosis and treatment plan for your specific case of melasma.


Can you get Melasma when you are not pregnant?

Yes, it can occur in both men and women who are not pregnant. Other triggers of melasma can include sun exposure, genetics, and certain medications.


Sun exposure is a common cause of melasma, and it can be triggered or exacerbated by spending long periods in the sun without adequate protection. In addition, certain medications, such as birth control pills, hormone replacement therapy, and some antibiotics, can increase the risk of developing melasma.


Genetics can also play a role in the development of melasma, as it tends to run in families. If your family members have melasma, you may be more likely to develop it as well.



Is it Melasma or Hyperpigmentation?


Melasma is a type of hyperpigmentation, which is a general term used to describe any area of skin that is darker than the surrounding skin due to the excess production of melanin. Melasma is a specific type of hyperpigmentation that occurs in patches on the face, particularly on the cheeks, forehead, nose, and upper lip.


However, there are other types of hyperpigmentation that can occur on the skin, such as post-inflammatory hyperpigmentation (PIH) that occurs after an injury or inflammation of the skin, or age spots that are a result of sun damage. While the causes of hyperpigmentation can vary, the treatment options are often similar.


Melasma & skin type


Melasma can affect people of all skin types, including those with black skin. However, melasma can be more challenging to treat in individuals with darker skin tones due to the increased risk of post-inflammatory hyperpigmentation (PIH), which is darkening of the skin after inflammation or injury.


Treatment options for melasma in individuals with black skin may include topical creams containing ingredients such as hydroquinone, tretinoin, and corticosteroids. Chemical peels and laser therapy may also be effective treatments for melasma, but it’s important to work with a dermatologist / Medical Aesthetic practitioner who experienced in treating darker skin tones to minimize the risk of PIH or complications .


It’s also important to protect your skin from the sun, as UV exposure can worsen melasma and lead to further hyperpigmentation. Wearing sunscreen with at least SPF 30 and avoiding prolonged sun exposure can help prevent melasma from getting worse.


Melasma & Men


While melasma is mostly seen in women, men can also develop the condition. In fact, studies have shown that melasma affects approximately 10% of men.


The causes of melasma in men are similar to those in women, including sun exposure, genetics, and hormonal changes. Men who have a family history of melasma or who spend significant time in the sun without adequate protection may be more likely to develop the condition.


In addition, men who use certain medications, such as antibiotics or anti-seizure drugs, may be at higher risk for melasma. Other factors that can increase the risk of melasma in men include certain medical conditions, such as liver disease or thyroid disorders.


Melasma & HRT


Hormone replacement therapy (HRT) can increase the risk of developing melasma, as it can cause hormonal fluctuations that stimulate the production of melanin in the skin. Melasma can develop or worsen in women who are undergoing HRT, especially if the treatment involves oestrogen or progesterone.


It’s important to talk to your healthcare provider if you are undergoing HRT and notice any changes in your skin, including the development of dark patches or hyperpigmentation. They may recommend adjusting your HRT regimen or switching to an alternative treatment to help manage your symptoms.


Overall, while HRT can increase the risk of developing melasma, it may still be a beneficial treatment option for certain women. It’s important to weigh the benefits and risks of HRT with your healthcare provider and discuss ways to minimize the risk of developing melasma or other side effects.


How do you remove melasma / can it be removed?


Melasma can be a stubborn skin condition to treat, and there is no one-size-fits-all solution. Treatment options will depend on the severity of the condition, as well as the underlying causes. It can be a difficult one to treat. However, with proper treatment and management, it is possible to reduce the appearance of melasma and prevent it from getting worse.


It’s important to remember that melasma is a chronic condition, and even with successful treatment, the dark patches can recur. Therefore, it’s essential to maintain a consistent skincare routine and take steps to avoid triggering the condition.


Here are some common treatment options for melasma:


Topical treatments: Topical creams and gels containing ingredients such as hydroquinone, retinoids, and azelaic acid can help lighten the dark patches of melasma. These are often prescription only medicines therefore you will need a medically qualified prescriber.


Chemical peels: A chemical peel involves applying a solution to the skin that causes the top layers to peel off, revealing brighter, smoother skin underneath. Chemical peels can be effective in treating melasma but may require several treatments.


Micro needling: There is some evidence to suggest that micro needling can be an effective treatment for melasma. By creating small punctures in the skin, micro needling may help to break up the melanin deposits that cause the pigmentation seen in melasma. Additionally, the production of collagen and elastin stimulated by micro needling may help to improve the overall health and appearance of the skin. However, it is important to note that micro needling is not a cure for melasma and may not work for everyone.


Laser therapy: Laser therapy uses high-intensity light to target and break down the excess melanin in the affected areas of the skin. On disadvantage of this is the potential for post inflammatory hyperpigmentation therefore ensure you consider a medically qualified practitioner for this.


Sun protection: It’s important to protect your skin from the sun’s harmful rays to prevent further damage and to avoid triggering melasma. This includes wearing sunscreen with at least SPF 30, wearing hats and protective clothing, and avoiding prolonged sun exposure.



Melasma & the NHS

In the UK, melasma is a non-life-threatening condition, and the National Health Service (NHS) may not cover treatment for cosmetic reasons alone. However, if melasma is causing significant psychological distress or is affecting an individual’s quality of life, they may be eligible for treatment on the NHS.


To receive treatment for melasma on the NHS, individuals will need to be referred to a dermatologist by their general practitioner (GP). The dermatologist will assess the severity of the condition and determine the most appropriate treatment plan.


Treatment options for melasma on the NHS may include topical creams, such as hydroquinone, tretinoin, or corticosteroids, or in some cases, chemical peels or laser therapy. The specific treatment plan will depend on the individual’s skin type, the severity of their melasma, and any underlying medical conditions.


It’s important to note that not all treatments for melasma are available on the NHS, and some may require funding through private healthcare or self-funding. Additionally, some NHS dermatology clinics may have long wait times for non-urgent cases, and individuals may need to consider private dermatology clinics for faster access to treatment.


Overall, while treatment for melasma on the NHS may not always be available or covered, individuals can work with their GP and Medical Aesthetic Practitioner to explore all possible options and find the most effective and affordable treatment plan.


For more information on any aspects of this blog contact Nicky at NR Aesthetics & Skin Clinic based in Bromsgrove Worcestershire to arrange a face-to-face consultation & skin analysis.