Melasma is a common pigmentary problem affecting Asian skin
- Brownish patches over the forehead, temples, nasal bridge, upper lips and jawline.
- Causes genetics, hormonal and UV exposure.
- Worsening or appearance of melasma is often reported after pregnancy, hormonal pills/ oral contraceptive pills, sun exposure.
Melasma Treatment Options
1. Topical Applications
- Sun Block : Advisable to apply on a regular basis, it might not treat or cure the condition but DOES help to prevent it from worsening
- COMBINATION CREAM (hydroquinone, steroid & tretinoin) OR CYSTEAMINE. Help to lighten melasma and maintain it in that state (to be administered by doctor)
- LASER : Nd:yag lasers, pico lasers, yellow lasers, fractional lasers have all been used to treat melasma. Doctor's consultation required as lasers can cause worsening of condition if not adminstered appropriately.
- INTENSE PULSE LIGHT (IPL): Does a good job in brightening the face and help reduce superficial pigmentation such as epidermal melasma. Care needed as IPL associated burns are a concern if not adminstered correctly.
- CHEMICAL PEEL: Chemically exfoliate superficial pigmentations. Relatively unpredictable with higher chance of complications.
3. Oral Medications
- TRANEXEMIC ACID: Can lighten Melasma significantly. But with it's side effects, a detailed doctor consultation would be required.
Melasma pigment issues has to be treated over a long period. The most effective treatment plan is one that combines all modality : topical, oral and procedures.
Maintenance is absolutely necessary and the melasma may recur when treatment has been ceased.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)