Melasma

It can be concerning if you start to notice areas of brown or greyish pigmentation developing on your skin, particularly on your face, or sometimes on your arms, neck or back. 

You may have a skin condition called melasma, the most common cause of hyperpigmentation. It’s more often seen in those with darker skin, but it can affect anyone, especially if you’re pregnant or taking the combined contraceptive pill. 

What is melasma?

Melasma - also known as ‘chloasma’ or ‘pregnancy mask’ - occurs when there is an overproduction of melanin, the pigment responsible for our skin colour. This produces characteristic brown or brown-grey patches with mottled pigmentation on the surface of your skin. 

It’s a harmless, non-cancerous condition, but we understand how it can be unsettling if your appearance has been affected. It’s good to know therefore, that in many cases it simply resolves over time or if it persists, we have a team of Consultant Dermatologists who are experts in managing and treating melasma. 

What Does Melasma Look and Feel Like?

The pigmentation from melasma usually appears on your face, in irregular patches that occur symmetrically on both sides. These mottled areas of skin are not raised, itchy or painful, and are not contagious. 

Areas of melasma are flat and can affect the following areas: 

• Forehead
• Upper lip
• Nose
• Chin

If other areas of your skin have been exposed to the sun, such as your forearms or neck, you may develop pigmentation there too. 

Who is most likely to be affected by melasma?

You are more likely to develop melasma if you have dark skin or tan easily. It’s also extremely common among pregnant women. In fact, the British Association of Dermatologists estimates that around 50% of women develop the condition during this time. Melasma is often triggered by hormonal changes, and therefore can also develop if you are on the contraceptive pill or taking HRT. 

There’s also quite a strong chance that you may develop melasma if someone in your family has the condition, and at least a third of people with melasma report that close relatives have it too.  

What Causes Melasma?

Although the exact cause is not known, experts believe melasma is caused by pigment producing cells — known as melanocytes — producing too much of the pigment melanin. 

This process can be triggered by several factors, including: 

• Pregnancy: around 50% of women who are pregnant experience melasma, triggered by hormonal changes during this time – in most cases it clears up by itself
• Menopause: the hormonal fluctuations during this time are a factor in the onset or increase in melasma
• Hormone based medication: being on the contraceptive pill or taking HRT (hormone replacement therapy) can cause or increase melasma in some women.
• Exposure to UV light from the sun or sunbeds: this is one of the main causes of melasma or it can make an existing condition worse.
• Genetics: a family history of melasma is known to increase your chances of getting melasma 
• Medications: very occasionally certain medications, such as anti-epilepsy drugs, can trigger melasma 
• Makeup and skincare: perfumed skincare products or soaps as well as certain makeup can sometimes lead to melasma or make it worse

How is Melasma Diagnosed?

Our Consultant Dermatologists have extensive experience in diagnosing melasma based on its visual appearance. During your consultation, we’ll carefully examine your skin using a dermascope and check for any other possible conditions. In rare instances, if we suspect something more serious, such as skin cancer, we may take a small skin sample —  a biopsy — using a local anaesthetic. 

Does Melasma Go Away On Its Own?

If you have developed melasma during your pregnancy, it often goes away after childbirth and you may not need any treatment. However, it may come back, especially during another pregnancy 

As part of a personalised treatment plan, our specialists help you work out what the triggers are for your melasma. For example, if you reduce your exposure to sunlight or stop taking HRT your melasma may fade or,  in some cases, disappear altogether. However, any significant changes to your medication should always be carried out under the supervision of your doctor. 

Can Sun Protection Help Treat Melasma?

UV rays stimulate the production of melanin in your skin and can cause your melasma to worsen, or new patches to appear.  Therefore, one of the most important things you can do to stop your melasma from getting worse is to use effective sun protection. 

This includes: 

• Avoiding the sun as much as possible, especially between 11am-3pm 
• Using sunscreen (ideally SPF 30 or above with a high UVA rating) 
• Sunscreen containing iron oxides can provide extra protection
• Keeping exposed areas of your skin covered with clothing 
• Wearing a wide brimmed hat, to keep your face, neck and ears protected from the sun 
• Wearing UV protected sunglasses

What is the treatment for melasma?

In order to work out a treatment plan, our specialists will first look at  what is causing your melasma and what your triggers are. For many people, using regular and effective sun protection and avoiding known triggers is enough to lessen or even eliminate their melasma. 

For others, although there may be no permanent cure, we offer highly effective treatment options which can help improve the appearance of your melasma, as well as prevent it from returning over time. 

This includes prescription-only topical creams, individually formulated by our Consultant Dermatologists according to your particular needs. We use powerful evidence-based ingredients that may contain a combination of the following: 

• Hydroquinone: prevents pigment cells (melanocytes) from producing melanin
• Tretinoin
• Hydrocortisone 
• Retinoids
• Azelaic acid
• Vitamin C 

Further specialist treatment for melasma

We may also suggest the following treatment options, depending on your level and type of melasma: 

• Chemical peels: these can removal the outermost cells of your skin that contain the pigment
• Microneedling: can help topical creams penetrate further into your skin, for more effective results
• Laser therapy: works by removing the outer layer of your skin or targeting the pigment producing cells. 

Why choose The Medical Chambers Kensington?

Our team of leading Consultant Dermatologists have extensive experience in treating melasma. We only use gold standard topical medication and create a personalised treatment plan, which we carefully monitor and adjust according to the way your skin responds. Alongside this, we make sure you have an optimum skincare routine, to help ensure the best results from your treatment plan. 

Visiting our private London Clinic

We’re here to offer our care and expertise, with appointments often available at short notice. If you are concerned about your skin, please telephone 020 7244 4200 or make an appointment online.