Melasma/Chloasma or Facial Pigmentation

Melasma or chloasma is characterized by abnormal pigmentation on the face. Women with an olive complexion are more frequently affected and it is thought to result from a combination of hormonal change and sunlight. Melasma is caused by the overproduction of pigment by the pigment producing cell of the skin called the melanocyte. Women may experience melasma for the first during pregnancy or following the initiation of the oral contraceptive pill.

How can it be treated?

Treating melasma is difficult and requires skill and patience. It is better to start carefully and slowly with treatment rather than expect immediate results. Over aggressive treatment may make melasma worse.

• General tips: sun protection and avoidance, cessation of oral contraceptive pill if possible
• Bleaching creams: help prevent new pigment and may bleach some existing excessive pigmentation. These work slowly but can achieve excellent responses with patience. These creams include but are not limited to azelaic acid and kojic acid. Extemporaneous formulas that are made by a compounding pharmacist are often prescribed by dermatologists.
• Chemical peels: lactic acid and salicylic acid used regularly will help bleach pigmentation when preformed carefully over a period of time
• Fractionated laser resurfacing produces excellent results when done patiently and carefully.

Remember, after treatment pigmentation can reappear on re-exposure to summer sun or as a consequence of hormonal factors.