The British Association of Dermatologists wants you to know that no matter how irritating you find dermal melasma, it is completely harmless. Dermal melasma--a condition characterized by areas of brown, blue or gray hyper-pigmentation on the face, neck or forearms--is not contagious, and it will not turn into skin cancer. In fact, if left untreated, the condition may even disappear on its own. Still, if you are like a lot of people, the sudden appearance of dark splotches on your skin may send you racing to the dermatologist's office hoping for a quick fix.
Types
Dermal melasma occurs when an increase in skin pigmentation occurs below the surface of the skin. Often appearing on the cheeks, nose or jaw, dermal melasma has an indistinct border and is often symmetrical, appearing equally on both sides of the face. Due to its location under the skin, dermal melasma is often resistant to treatment. If your doctor suspects dermal melasma, he will likely examine your skin under a special black light to determine the type and extent of your condition.
Pregnancy
People sometimes refer to dermal melasma as "the mask of pregnancy" because it afflicts so many pregnant women. If you are pregnant and develop melasma, do not panic. Pregnancy-related melasma is generally considered a temporary condition and will likely disappear on its own within a few months of giving birth. That said, dermal melasma may recur with subsequent pregnancies, often with greater intensity.
Sun Exposure
Exposure to the sun can cause melasma, especially in tan or dark-skinned individuals. When you are in the sun, your body increases its production of the skin pigment melanin. This increase is what causes the body to darken in the sun, and what may ultimately lead to dermal melasma. If you have melasma, it is important to use sunblock on a daily basis to keep your condition from worsening. If you are a dark-skinned woman with a family history of dermal melasma, regular use of sunblock may be especially effective at keeping the condition at bay.
Causes
Many different causes of dermal melasma have been identified. According to Dermanetwork.org, fluctuations in the hormones estrogen and progesterone may contribute to melasma, as well as pregnancy, the use of birth control and hormone replacement therapy during menopause. Other causes may include the use of scented cosmetics and soaps, the use of tetracycline, the use of antimalarial medication or other drugs derived from quinine, and family history.
Treatment
The American Academy of Dermatology says devising an effective treatment plan for melasma is rarely straightforward. Dermal melasma is especially resistant to treatment and may require a combination of creams, laser therapy and peels to correct.
Treatment options include topical creams containing salicylic acid, glycolic acid or lactic acid. Tretinoin, a topical retinoid, may improve skin color in some people, but it is sometimes difficult to tolerate and can cause dermatitis. Intense pulsed light (IPL), a laser that destroys skin pigment, may prove the best option for eradicating dermal melasma. While effective, you may require several IPL treatments to achieve optimal results.
Considerations
If you choose to treat your dermal melasma, keep in mind that it often takes a long time to see results. If you do manage to eliminate the melasma with creams or lasers, exposure to sun, pregnancy or hormonal changes can cause the pigment to reappear at any time.
This article is intended as a general overview of dermal melasma only and should not replace medical advice. If you have dermal melasma, consult a reputable dermatologist to discuss the best possible treatment options.
References
- British Association of Dermatologists: Melasma
- Dermnet NZ: Melasma
- Skin and Aging (journal); "Rising to the Melasma Treatment Challenge"; Dr. Heather Woolery-Lloyd; March 15, 2003
- Derma Network: Melasma--Frequently Asked Questions
- American Osteopathic College of Dermatology: Dermatologic Disease Database--Melasma
