Melasma is predominantly a facial condition leading to a disorder of hyperpigmentation. It manifests as irregular patches of increased pigmentation primarily on the forehead, cheeks, nose and jawline. It can cause debilitating psychological distress due to changes in appearance of facial skin.
Melasma arises due to a complex interplay between genetic predisposition, hormonal influence, and visible light exposure. The condition usually starts in females of child bearing age; males can less commonly also be affected. The trigger is often unknown although use of hormonal contraception, pregnancy and hormone replacement therapy are often cited. Skin scientists believe the disease occurs as circulating oestrogen and progesterone interact with visible light to stimulate the pigment cells (melanocytes) into making excess melanin (pigment). This increase in pigmentation is irregular and tends to focus on the bony prominences of the cheeks, nose, forehead and jawline. Coupled with this, there is an irregular formation of blood vessels in the dermis.
Effective management of melasma necessitates a comprehensive, multi-pronged, evidence-based approach. Photoprotection stands as the cornerstone of treatment. As this condition is thought to be driven by visible light, meticulous sun protection including a sunscreen that blocks visible light along with physical barriers such as wide-brimmed hats and sunglasses is essential. Sun avoidance during peak hours, coupled with the application of topical antioxidants further defends the skin.
In addition to fastidious sun protection, at Self London we aim for a remission of hyperpigmentation. Treatments can involve topical depigmenting compounds to reduce the excess pigmentation in higher layers of the skin, chemical peels to remove pigmentation in middle layers of the skin and laser therapy to remove both superficial and deep layers of pigmentation. Alongside this, a course of oral therapy to normalise the aberrant vasculature will be offered.
Once remission of hyperpigmentation is achieved, maintenance treatment is initiated. At Self London this includes an individualised skincare plan using cutting edge prescription antioxidants as well as skincare that is nourishing and anti-inflammatory.
We offer Consultant Dermatologist-led bespoke management including meticulous monitoring to provide a personal and effective solution to managing melasma both short and long-term.
