What Is Melasma And What Are Your Treatment Options? by Marie Jhin What Is Melasma And What Are Your Treatment Options?Melasma is a widespread skin condition that affects approximately 5 million people in the United States (Melnick et al.) Due to the high demand for solutions to melasma, many treatment options are available. What is melasma?Melasma is a skin condition that causes symmetrical, dark discolored patches to form on the face, particularly the forehead, cheeks, upper lip, and chin areas. Melasma affects both men and women of all skin tones. However, it is typically more common in women and those with darker skin types (Ogbechie-Godec and Elbuluk). What causes melasma?Melasma can be chronic, meaning it will return if the underlying causes are not addressed. There are two main causes of melasma: sun damage and hormonal changes (American Academy of Dermatology Association). When the skin is exposed to the sun, the sun’s ultraviolet rays cause melanocytes (cells that create pigment in the skin) to produce excess melanin, leading to the formation of melasma and dark spots on the skin. Hormonal changes can also cause melasma, such as birth control, hormone therapy, or pregnancy. Melasma is extremely common during pregnancy due to hormonal changes and is often called a “pregnancy mask”. Related: Causes of Melasma: Answered!Why treat melasma?If untreated, melasma can negatively affect many people’s emotional and psychological well-being, as well as the overall quality of their lives (Handel). After treating melasma, people are able to gain confidence in their appearance again.What are my treatment options?Topical creams are applied directly to the skin. Common ingredients include hydroquinone, tretinoin, niacinamide, kojic acid, azelaic acid, and tranexamic acid (Ogbechie-Godec and Elbuluk). These ingredients help prevent the production of excess melanin and remove existing melasma. Risks and side effects include irritation, erythema (redness), and post-inflammatory hyperpigmentation (PIH) (Trivedi). However, topical creams are recommended due to convenience of application, affordability, effectiveness, and safety—especially with dermatologist supervision.Recommended: The Spot CreamOral medications such as tranexamic acid blocks the chemical reaction and process of dark spot formation, and reduces the process of excess melanin production. Risks and side effects include mild gastrointestinal discomfort, heavy bleeding, hypomenorrhea (infrequent menstruation), allergic skin rashes, alopecia (hair loss), and blood clots (especially if you are on hormonal birth control and or have a personal/family history of clots or strokes) (Grimes).Chemical peels erase melasma and unwanted melanin by removing the top layer of the skin. These peels tend to cost $150 - $3,000 depending on the intensity (average cost is $673). Risks and side effects include burning, irritation, erythema, edema (swelling), scarring, and infection (Anitha). Safety measures for using chemical peels are extremely important. After undergoing a chemical peel, it is vital to follow the dermatologist’s aftercare instructions such as using proper sun protection and refraining from makeup application until the skin heals.Recommended: The Spot PeelLaser treatments target excess melanin in the skin with tools such as flash lamp light source or high intensity laser beams (Trivedi et al.). Laser treatments usually consist of 3 - 4 sessions, with the cost being $250+ per treatment. Risks and side effects include post-inflammatory hyperpigmentation (PIH) and rebound melasma (Trivedi et al.).How long does it take to see results from melasma treatments?The time it takes to see results varies for each individual, depending on the strength of treatment and severity of melasma.Topical creams: 6-12 weeksOral medications: 8-12 weeksChemical peels: 4 - 8 daysLaser treatments: 3 - 6 monthsHow do I prevent melasma in the future?To prevent melasma from recurring, it is crucial to use sun protection daily. Sun avoidance is highly recommended but not always feasible. Proper sun protection includes using a mineral-based sunscreen with SPF 30+, wearing a wide-brimmed hat, and staying in the shade. In addition, avoiding heat sources such as fires, saunas, computer screens, incandescent lights also helps prevent melasma. For hormonal melasma, prevention includes stopping the use of hormonal medications or becoming pregnant. Related: What Sunscreen To UseWhat’s the best treatment for melasma?The best treatment for melasma is The Spot Cream and The Spot Peel. Formulated by top Board-Certified Dermatologists, Musely’s freshly compounded medications are 10x more potent and effective than OTC products or prescription alternatives. Musely also offers a variety of customized formulas, depending on the individual’s skin concerns.Another benefit of FaceRx treatments is convenience. There’s no need to go to the doctor’s offices or pharmacies; medication is delivered straight to the patient’s door — no shipping fees and tax-free.Related: Learn About Our Melasma TreatmentSources: Anitha, B. “Prevention of complications in chemical peeling.” Journal of cutaneous and aesthetic surgery vol. 3,3 (2010): 186-8. doi:10.4103/0974-2077.74500Grimes, P E et al. “New oral and topical approaches for the treatment of melasma.” International journal of women's dermatology vol. 5,1 30-36. 20 Nov. 2018, doi:10.1016/j.ijwd.2018.09.004Handel, Ana Carolina et al. “Melasma: a clinical and epidemiological review.” Anais brasileiros de dermatologia vol. 89,5 (2014): 771-82. doi:10.1590/abd1806-4841.20143063“Melasma: Who gets and causes.” American Academy of Dermatology Association, www.aad.org/public/diseases/a-z/melasma-causes. Accessed 15 June 2021.Melnick, Stephen et al. “Hyperpigmentation in a middle aged woman: a common yet underdiagnosed condition.” Journal of community hospital internal medicine perspectives vol. 6,3 31544. 6 Jul. 2016, doi:10.3402/jchimp.v6.31544Ogbechie-Godec, Oluwatobi A, and Nada Elbuluk. “Melasma: an Up-to-Date Comprehensive Review.” Dermatology and therapy vol. 7,3 (2017): 305-318. doi:10.1007/s13555-017-0194-1 Trivedi, M K et al. “A review of laser and light therapy in melasma.” International journal of women's dermatology vol. 3,1 11-20. 21 Mar. 2017, doi:10.1016/j.ijwd.2017.01.004