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Melasma is a common skin condition that presents as tan to brown pigmented patches often on the face. Melasma is caused by the overproduction of pigment by melanocytes (pigment-producing cells) within the skin. Unlike moles, there is not an increase in the number of melanocytes, but only the pigment which is produced by melanocytes. Multiple factors have been implicated in the cause of melasma including hormonal fluctuations, sunlight/ultraviolet radiation, as well as genetic factors. Melasma is commonly seen during or after pregnancy as well is in patients who are on birth control or hormonal therapy. Sun exposure can exacerbate the condition and make it more obvious.

Treatments for melasma include:

  • Hydroquinone cream: Bleaching cream which helps reduce the production of pigment by melanocytes.

  • Tretinoin cream: Increases the turnover of cells and helps resurface the skin. Tretinoin often works best when combined with a bleaching product such as hydroquinone.

  • Sunscreen: Protection from the sun and liberal use of sunscreens is equally important in the treatment of melasma as prescription medications. Because the sun and UV radiation also stimulate the production of pigment, it is very important to protect your skin from the sun. Despite proper treatment, melasma can return with exposure to sun light and UV radiation.

  • Azelaic acid: Has also been shown to decrease the activity of melanocytes, although less effective than hydroquinone.

  • Phototherapy/Laser therapy: Laser and light therapy have shown to be very effective in the treatment of melasma, especially when bleaching creams don’t help.

  • Discontinuation of birth control: Stopping hormonal therapy such as birth control can help with melasma, although risks and benefits must be considered.

Depending on your skin type and clinical symptoms, our dermatologist can help determine the best treatment option for you.

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