Types of Melasma - Causes, Symptoms & Best Treatments

The dark and uneven patches that melasma causes on the skin can make anyone with this condition shrink from embarrassment. It makes the surface of the skin look unkempt. While it is not contagious nor harmful, many individuals who suffer from it seek effective melasma treatments in Singapore. Despite many treatments available, there is no one-size-fits-all miracle cure that can make these unsightly patches disappear in an instant. This article takes a deep dive in understanding types of melasma, their causes, and the various treatments suitable for specific skin types

Melasma: What exactly is this condition?

Also known as chloasma, melasma is a condition that affects the surface of the skin. This condition commonly appears on the face, where dark patches that are symmetrical cover areas like the cheeks, chin, forehead, upper lip, and nose. The formation of melasma is linked to the body’s overproduction of the pigment that gives the skin its colour, called melanin.

People with darker skin are more prone to melasma, but it can also develop in fair skin. Notably, this skin condition is more rampant among women than men–the cause of its occurrence is associated with the changes in female hormones that may be due to pregnancy, use of oral contraceptives, and hormone replacement therapy. Aside from these triggers, melasma can become worse when the affected skin is unprotected and exposed to UV rays. Other causes of melasma also include genetics, medications, and skin type.

Melasma: What are the types of this condition?

It is easy to confuse melasma with other skin pigmentation conditions due to the similarity of the brown or gray-brown patches on the skin and the factors that trigger its development. Oftentimes, melasma can be mistaken for freckles, sunspots, post-inflammatory hyperpigmentation (PIH), and tinea versicolor. Hence, it is important that melasma is properly diagnosed, so that the right treatment is given and avoiding further damage to the skin.

There are three main types of melasma, categorized based on the depth of pigmentation:

Dermal Melasma – This is a deep type of melasma that occurs in the second layer of the skin. Dermal melasma is usually stubborn and intensive treatments may be needed to see improvements in the skin.
Epidermal Melasma – This type of melasma is characterized by darker patches that only affect the topmost layer of the skin. Epidermal melasma is responsive to treatments like laser therapies and topical creams.
Mixed Melasma – As the name suggests, this type of melasma is a combination of both dermal and epidermal melasma. Because of its nature, mixed melasma is more complex to treat and often needs a treatment approach that is more comprehensive to deal with pigmentation occurring on the surface level and deeper part of the skin.

Melasma: What are the various treatments available for different types of skin?

Treating melasma varies from one individual to another. Creating a treatment plan is carefully planned and customized according to the factors surrounding its occurrence. Doctors need to identify the condition’s underlying cause, assess the pigmentation’s severity, and consider the patient’s skin type.

The main goal of the treatment is to improve the appearance of the skin through pigmentation reduction and ensure that side effects are prevented to avoid skin irritation that may lead to further skin darkening.

Skin Tone: Fair to Medium
Type of Melasma: Epidermal

Treatment Options:

1. Topical Treatments

Chemical Peels: Glycolic acid or salicylic acid are active ingredients present in light chemical peels that can promote skin exfoliation and remove dead skin cells. Repeated treatment can lead to pigmentation reduction over time.
Vitamin C: A potent antioxidant, Vitamin C promotes skin brightness and suppresses the production of melanin. This treatment can be administered through the application of serums on the target areas.
Hydroquinone: Considered as the gold standard in treating melasma, hydroquinone works its wonders by hindering the production of an enzyme called tyrosinase. This enzyme is responsible for the production of melanin. Hydroquinone can be bought over-the-counter. Stronger types of hydroquinone can be obtained with a prescription. This treatment effectively lightens dark spots and is often effective on fair to medium skin tones.

2. Laser Treatments

Fractional CO2 or Intense pulsed light (IPL) are laser treatments that have proven to be effective in reducing the appearance of melasma for individuals with fair to medium skin tones. This type of treatment should be done with extreme care as it can cause post-inflammatory hyperpigmentation when improperly done.

Skin Tone: Olive to Medium Dark

Type of Melasma: Dermal

Treatment Options:

1. Topical Treatments

Azelaic Acid: A well-tolerated treatment that effectively reduces melasma without causing irritation, unlike hydroquinone. It works by inhibiting melanin production and exfoliating dead skin cells, helping to lighten dark patches.
Hydroquinone: When used in lower concentrations (2%) and combined with other lightening agents like azelaic or kojic acid, hydroquinone can effectively diminish melasma’s dark patches.
Niacinamide: A natural antioxidant with anti-inflammatory properties, niacinamide brightens the skin and reduces pigmentation without irritation, making it an excellent option for sensitive skin.

2. Laser Treatments

Fractional Laser Resurfacing: This procedure stimulates collagen production and resurfaces the skin from within, effectively addressing pigmentation at both the dermal and epidermal levels.
Q-Switched Nd: YAG Laser: A safe and effective option for medium to dark skin tones, this laser treatment breaks down melasma without harming the surrounding skin. It is particularly recommended for dermal melasma.

Skin Tone: Darker Tones

Type of Melasma: Mixed

Treatment Options:

1. Topical Treatments

Azelaic Acid: Highly effective for melasma on darker skin tones, azelaic acid reduces melanin production and lightens affected areas without causing irritation or post-inflammatory hyperpigmentation. It is a safe and well-tolerated option for long-term use.
Chemical Peels (Lactic Acid): Lactic acid is a gentle yet effective exfoliant that removes the outermost layer of skin, promoting a brighter complexion. It is particularly suitable for individuals with darker skin tones, offering a gradual improvement in pigmentation.
Kojic Acid: A milder alternative to hydroquinone, kojic acid effectively fades melasma with consistent use. It is a gentle yet powerful skin-lightening agent that helps even out skin tone without causing excessive irritation.

2. Laser Treatments

Q-Switched Nd: YAG Laser: This laser technology targets melanin at deeper skin layers without compromising the skin’s surface. It is a safe and effective option for individuals with darker skin tones, minimizing the risk of post-treatment pigmentation issues.

For All Skin Types:

Sunscreen: Although sunscreen does not directly lighten dark patches of melasma, regular use is crucial in preventing thttps://www.verticalwise.com/replace-makeup-products/he condition from worsening. Applying sunscreen consistently to areas affected by melasma helps protect the skin from further pigmentation and damage caused by UV exposure.