(Board Certified Dermatologist, Yolanda C. Holmes, MD, FAAD., specializing in the treatment of adult acne, rosacea, eczema, mole removal, razor bump removal, wrinkle reduction, non-surgical cellulite removal, complexion blending, CLICK HERE to learn more about our on-line patient consultations)

Melasma is defined by the development of brown patches on the face. It typically affects the forehead and the cheeks but can also affect the chin and upper lip.

The cause of melasma is unknown. The pigment producing cells(melanocytes) of the skin produce too much pigment ( melanin) in the affected areas.

It is believed that there is a hormonal component to melasma. Women are much more likely to develop melisma than men. Many times it will develop after childbirth, menopause or a change in contraception. Many patients who suffer from melasma have other members who are also affected. Melasma if more commonly seen in people of color but can affect anyone.

Sun exposure is a key trigger for melasma. The sun produces ultraviolet light which stimulates the pigment producing cells to produce pigment. It is extremely important that sunscreen be worn all year long.

A dermatologist can usually diagnose melasma just by looking at the skin. If diagnose is unclear, a Wood lamp exam or skin biopsy is done.

A skin biopsy is a procedure that evaluates the skin the affected areas. The skin is numbed using an injectable anesthetic and a small amount of skin (less then the size of pencil eraser) is removed. That removed skin is evaluated under the microscope to determine the diagnosis. The discomfort associated with a skin biopsy is minimal but it provides valuable information to the dermatologist. Skin biopsies are done frequently.

Treatments for melasma include topical products (applied to skin) and procedures.
Hydroquinone is found in creams and lotions and is used to lighten the skin. A prescription is required for higher strength products but products that contain lower strengths of hydroquinone can be purchased over the counter.

Tretinoin is another topical products that can be used to create a more even tone of the skin. It can be irritated so many times in combined with a corticosteroid cream to lessen its irritation.

Various procedures are used to improve Melasma.
Chemical peels improve melasma by lightening the skin. Glycolic, salicylic and other combination peels (Vi Peel) work to even the skin tone decrease the dark patches. Microdermabrasion is similar to using “sandpaper on the skin”. Is uses a manual exfoliation process which helps with evening the skin tone. Laser are also used to target pigment cells to light dark spot on the skin.

Our signature service - Complexion Blending combines but microdermabrasion and laser to make the patches of melasma smoother and lighter. Is a very effective treatment for melasma.

If you suspect that you suffer from melasma please avoid direct sunlight as much as possible. Wearing a wide brimmed hat and applying a sunscreen with zinc oxide or titanium dioxide are important weapons to help protect your skin.

Schedule an appointment with Washington DC Dermatology for your personalized treatment options.

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