Melasma: Brown Patches on the Face — Causes and Modern Treatment

Melasma is brown or grey-brown patches on the face, usually symmetrical on the cheeks, forehead, upper lip and chin. It is not dangerous or contagious, but it is chronic, darkens after sun exposure and is a real cosmetic concern for many people. The good news: with the right treatment and protection the patches can be lightened considerably.

Why does melasma appear?

In melasma the skin's pigment cells — melanocytes — are overactive. Triggers include:

• sunlight — ultraviolet and even visible light; the main factor;
• hormones — pregnancy (hence the name "mask of pregnancy"), hormonal contraceptives;
• genetics — it is more common when relatives have it;
• heat — kitchens, saunas, hot workplaces;
• irritating cosmetics and aggressive procedures.

Melasma is most common in women aged 20–50, but men get it too.

How to tell melasma from other spots

Not every patch on the face is melasma:

• sun spots (lentigines) — sharply defined, more common with age;
• marks after acne and inflammation — left where a rash was;
• moles and other pigmented lesions — these should always be checked with dermoscopy.

An examination and dermoscopy show the type of spot and how deep the pigment lies — and that decides the treatment.

How is melasma treated?

Melasma cannot be erased for good, but it can be lightened considerably and kept under control. Treatment usually has several steps:

• Strict sun protection — every day, even in winter and on cloudy days: broad-spectrum SPF 50, ideally tinted, which also blocks visible light. Without it, no treatment works.
• Topical products — pigment-reducing creams; the product and routine are chosen by the doctor.
• Gentle peels — as a course, without irritating the skin.
• Laser toning — gentle low-energy protocols on lasers such as Hollywood Spectra break the pigment down gradually. More: Pigmentation treatment with Hollywood Spectra.

Important: strong peels, "hot" lasers and IPL can make melasma darker. That is why the method and energy should be chosen by a doctor experienced with melasma. On IPL and lasers for other types of pigmentation: Pigmentation treatment with IPL Lumecca.

Keeping melasma from coming back

• Apply sunscreen every day and reapply every 2–3 hours.
• Wear a wide-brimmed hat and sunglasses.
• Limit saunas and hot baths.
• Discuss any new hormonal medicine with your doctor.
• Do not rub patches with "whitening" home remedies — lemon, vinegar, peroxide: they burn the skin and darken the patch.
• Keep up the skin care and maintenance treatments your doctor recommends to hold the result.

Melasma treatment in Fergana and Kokand

At Radeski Skin Clinic a dermatologist-cosmetologist examines the patches with a dermatoscope, tells melasma apart from other pigmentation and builds a step-by-step plan using aesthetic device treatments.

• Skin spots — in brief;
• Pigmentation treatment in Fergana;
• Pigmentation treatment in Kokand.

Melasma takes patience: results start to show within weeks, and sun protection has to become a lifelong habit.