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What is Melasma?

Melasma is a skin condition with excessive production of pigment called melanin resulting in the patchy discoloration of the skin. Melanin is the natural pigment produced by our body to make up our skin, hair and eye color. Melasma may be triggered by hormonal changes and often may be referred to as a Pregnancy mask. This type of hyperpigmentation can also be triggered by birth control pills, menopause or may be just hereditary.  The patchy discoloration is most commonly found on areas that may be frequently exposed to sunlight, such as the nasal bridge, cheeks, forehead, and upper lips.

There are no other physical symptoms with melasma, but the condition can be emotionally irritating as it can cause significant change to the appearance of the skin.

How is Melasma Diagnosed?

Melasma is commonly diagnosed by visual examination of the skin but it can sometimes represent itself similarly to other conditions. In this case, your physician may take appropriate steps to properly diagnose your condition.

What causes Melasma?

Because Melasma is a pigmentation disorder, doctors believe it to be the result of malfunctioning melanocytes, the cells that produce melanin responsible for the skin’s coloration.

According to the American Academy of Dermatology women account for 90% of all melasma cases, and women who have darker complexions or who are pregnant are more likely to develop the condition.

Other factors in the development of melasma include stress, thyroid disorders, hormonal birth control usage, and increased exposure to the sun’s ultraviolet rays which may damage melanocytes.

What treatments are available for Melasma?

Melasma patches have been known to fade for some women post-pregnancy or after discontinuing birth control. This would be referred to as transient type melasma.

Others may experience persistent type melasma that may last years or never quite fully dissipate. Although no physical harm is caused by melasma, changes in one’s appearance may warrant the desire for treatment.

In persistent types, treatment is effective but continued therapy is required to maintain control of the patchy discoloration.

There are many treatments now available that are very effective in the treatment of melasma.


There are quite a few topical treatments, including Hydroquinone, tretinoin, and/or corticosteroids which all have an effect on tyrosinase, an important enzyme that melanocytes use to create melanin. Inhibiting tyrosinase can help slow the production of pigmentation, lightening the discolored skin patches.

Cosmelan de-pigmentation treatment is a very powerful topical therapy for stubborn and deep pigmentation.  It contains combined ingredients that work together in reducing hyperpigmented patches and helps to  maintain control.

Other topicals include products like azelaic acid or kojic acid which also influence the activity of tyrosinase to slow down the hyperactive melanocytes that are overproducing melanin.

Other Treatments

There are other procedures available which can be used alone or in combination with topicals such as:

– Vibrodermabrasion
– Laser Treatment
– Light Therapy
– Chemical peel

What should I expect with the treatment?

To start, you and Dr. Brandish will develop an individualized treatment plan to determine what topical or other treatment may be most effective for your individual case.

For topical medications, treatment may take several weeks before noticeable improvements show. That being said, topicals like Hydroquinone containing products tend to be the most common first-line approach to treatment of melasma.

Combination therapy with vibradermabrasion and cosmelan mask plus home therapy has shown consistent effective treatment of melasma.

Melasma Summary

Melasma is a pigmentation skin condition characterized by the appearance of dark brown/grey patches on the skin. It primarily affects areas that receive more sunlight exposure, like the face and other areas of the upper body. It’s diagnosable by clinical examination but your physician may take further action to better distinguish it from other similar-looking conditions. Many different treatments are available for melasma, from topicals to medical procedures like chemical peels, laser, and dermabrasion. Topicals like hydroquinone containing products are generally the gold-standard in treatment, and although treatment may last several months or more, it is usually quite effective in reducing the discolored patches. Continued maintenance treatment is key in melasma therapy.

How do I get started with Melasma Treatment?

If you’re interested in hearing more or in scheduling an appointment, contact our office at

and we’ll take care of you. We offer free consultation appointments as well if you’d like to simply go over any problem areas and discuss treatment options for Melasma with Dr. Brandish.