Melasma is a patchy brown discoloration of the face, particularly occurring in sun exposed areas of the forehead, cheeks, and upper lip. The cause is unknown, but it is often associated with pregnancy (also known as the “mask of pregnancy”) and oral contraceptive use. 90% of people with melasma are women. Patients with darker skin color, particularly Asians and Hispanics, are more prone to develop melasma. Sunlight always exacerbates the condition.
At The Bellevue Laser & Cosmetic Center, we offer a number of different treatment options for melasma. Our providers may recommend starting with a prescription topical medication that contains the bleaching agent, hydroquinone, such as the Obagi NuDerm skin care system. If you have already tried bleaching agents or wish to be more aggressive with the therapy, she may recommend a series of chemical peels such as the Vitalize peel. Intense Pulsed Light treatment (IPL) is also effective for some patients. For more stubborn melasma, our providers may also suggest the Palomar LUX 1540 fractional laser treatment. Both the IPL and the laser therapy generally require several treatment sessions.
Melasma is notoriously challenging to treat. Regardless of the treatment method, any amount of sun exposure can worsen the hyperpigmentation again. Therefore, sun avoidance and copious use of sunscreens is crucial in the treatment and prevention of melasma.