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What Is The Main Cause Of Melasma?

What Is The Main Cause Of Melasma?

Melasma is a common skin pigmentary condition. It can be triggered by sun exposure, genetics and hormonal changes.
Sunlight is considered the principal factor that triggers melasma. This happens when ultraviolet rays affect the cells that control pigment/colour (melanocytes) leading to excessive melanin production whichcauses brown or grey patches to appear on the face area of the skin.

About Melasma

The bridge of the nose, forehead, cheeks and upper lips are common melasma-affected areas since the face is most exposed skin to sunlight. Besides the sun, women with darker complexions and pregnant women are more likely to develop melasma compared to men. According to the American Academy of Dermatology, only 10% of all cases involved men.

The pigment melanin is responsible to define the colour of a person’s eyes, hair, and skin. The exposure from the sun, genetics, hormonal changes, inflammation and age can affect the production of melanin. Hyper-pigmentation is the result of the over-production of melanin which contributes to the appearance of dark spots and uneven skin tones. In contrary, underproduction of melanin (hypo-pigmentation) causes the skin to be free from spots.
There are three types of melasma; epidermal, dermal and mixed.
1. Epidermal melasma affects the top layer of the skin causing a well-defined border of brown patches due to the pigmentation.
2. Dermal melasma affects the deeper dermis level where the patches are in blue-grey patches.
3. Mixed melasma (a combination of epidermal and dermal) shows brown-grey patches. This type of melasma is harder to treat than the other two.

Identifying Symptoms of Melasma

The obvious symptom that can be observed with the naked eye is the development of discoloured patches on the skin. There are no other physical symptoms but at times melasma can disguise as other skin conditions. To confirm the skin condition, a dermatologist or medical aesthetic doctor may need to remove a small bit of skin (known as skin biopsy procedure) and run tests with it. 

Causes of Melasma

The reason hyperpigmentation occurs is still undecided by doctors. It may be due to the malfunction of melanocytes (colour-making cells) which then triggers the over-production of colour for normal skin. People with darker skin complexion are prone to develop melasma due to the number of melanocytes that they have in comparison with lighter-skin people. Other potential triggers for melasma are the changes in hormone (caused by pregnancy, hormone replacement therapy (HRT) or birth control pills), sun exposure and using skincare products that irritates the skin. Lastly, genetics play a factor as well.  

Changes in hormone

The changes in hormone that may be responsible for melasma are pregnancy hormones, hormone replacement therapy (HRT) or birth control pills. During pregnancy, endogenous hormones stimulate melanocytes to produce more melanin pigments. This subsequently causes the number of melanin pigments to be imbalanced and contributes to the cause of melasma. Women that undergo hormone replacement therapy and those taking birth control pills share similar hormonal changes as those that occur during pregnancy.

Sun exposure

UV exposure is a major factor in the development of melasma. More often than not, it affects women with darker complexity skin as they possess more melanocytes which if triggered, increases the production of melanin in their body and thus expose them to the risk of having melasma. Avoiding the sun and applying broad-spectrum high-factor sun protection are two simple but effective habits in avoiding the stimulation of pigment production.

Skin care product

Certain skincare products are not suitable for those with sensitive skin as irritation might occur. Therefore, careful choice of skincare product is important.

Genetic

Genetics play an important role in the development of melasma. An individual is also more susceptible to melasma if there is a positive family history of the condition.

Treatment options

If you are diagnosed to have melasma, there are treatment options can greatly reduce facial hyperpigmentation. Your doctor may also suggest treatment combinations for the best and soonest outcome.

Removal

This treatment is via laser therapy, intense pulse light or chemical peel and has been proven to help treat melasma. Potential side effects may include inflammation, irritation and a burning sensation.

Laser therapies (PICO, Q-Switched, Tixel, Sylfirm) 

Laser treatments are more precise than chemical peels. In laser therapies, high-energy lights are used to target the affected area as it removes hyper-pigmented skins cells at the surface or deeper level, depending on condition severity.

Chemical peels

Glycolic acid (AHA) is used frequently by dermatologies for chemical peeling. It induces the top layer of the skin to blister and subsequently peel off. As the skin sheds, new, unblemished skin will be revealed.

To regulate skin colouration, here are the few ingredients typically present in topical medical or skincare products to treat melasma.

Conclusion/ Final Thoughts

While melasma can be treated, the right procedure largely depends on the severity of your melasma. As the skin type and lifestyle of every individual are unique, no one treatment plan is guaranteed to work. If you are diagnosed with melasma, be sure to discuss with your dermatologist to identify the best treatments that may help.
No procedure can guarantee that melasma won’t reoccur, and in some cases of melasma the patches can’t completely vanish. Lifestyle changes are required to maintain the results of treatment, or you may have to maintain consistent treatment to reduce the risk of the melasma returning.

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