How Do I Get Rid Of Melasma (Dark Patches) On My Face

Are those annoying brown patches (melasma) on your face hitting your confidence? A lot of women tend to feel aged, thanks to the patches. But fret not! In this blog post, we are covering treatment options for melasma that are safe and dermatologically approved.

What Is Melasma?

Melasma is a skin condition that occurs most commonly on the face. Dark patches appear on part of the face due to excess production of melanin (skin pigment).

It is also called chloasma. The name comes from melas, the Greek word for black, or cholas, from the word green-ish.

Young women with darker skin complexion are more prone to developing melasma. But melasma can develop at any stage of your life.

Symptoms Of Melasma

Melasma causes dark patches on the face. Brownish colored patches appear on

• Cheeks
• Forehead
• Bridge Of The Nose
• Chin

Causes Of Melasma

Image: Shutterstock

• UV exposure
• Hormonal imbalances
• Birth control pills
• Pregnancy

Melasma is also referred to as 'mask of pregnancy', because dark patches that appear on the nose, cheekbones and jaws are prevalent while women are expecting.

A. Topical Treatments

Topical treatments for melasma include Iron oxide, Hydroquinone, Azelaic acid, Kojic acid, Tretinoin, Corticosteroids, Ascorbic acid and niacinamide.

1. Hydroquinone:

Hydroquinone (HQ), also known as dihydroxybenzene, is a hydroxy phenolic compound. Hydroquinone functions by lightening the skin. It is available in the form of a cream, lotion, gel or liquid.

Hydroquinone is found in over-the-counter formulas, but higher strength versions can only be obtained through a prescription.

HQ preparations are commonly used at concentrations varying from 2-5% and can be applied once daily. It inhibits the activity of Tyrosinase, a biological catalyst that triggers melanin production in melanocytes.

2. Azelaic Acid:

Azelaic acid inhibits the synthesis of hyperactive melanocytes, and has an antityrosinase activity.

Free radicals are known to contribute to hyperpigmentation and azelaic acid functions by reducing free radical production.

3. Kojic Acid:

Kojic acid (5-hydroxy-2-hydroxymethyl-4-pyrone) is a naturally occurring, hydrophilic fungal product. It is derived from certain species of Acetobacter, Aspergillus, and Penicillium.

It acts by inhibiting the production of free tyrosinase; it is also a potent antioxidant.

4. Tretinoin:

Tretinoin is a Retinoid that affects multiple steps in the melanization pathway. It promotes the rapid loss of pigment.

5. Corticosteroids:

Corticosteroids decrease the epidermal turnover and thus, may have a depigmenting effect. Corticosteroids have been combined with other agents in the treatment of melasma for years. They lead to epidermal atrophy (thinning and flattening of the epidermis).

6. Ascorbic Acid:

Ascorbic acid has antioxidant properties. It affects melanogenesis by preventing free-radical production and absorption of ultraviolet radiation.

Because it is almost devoid of side effects, it could be used alone or in combination therapy.

7. Niacinamide:

Niacinamide prevents the transfer of melanosomes from melanocytes to the keratinocytes. It could have some side effects like upset stomach, dizziness and rash. Consult your doctor before using it.

B. Oral Treatments

Oral treatments for melasma include Tranexamic acid, Polypodium leucotomos and Glutathione.

1. Tranexamic Acid (TXA):

When skin is exposed to sunlight, it leads to the synthesis of a plasmin activator, which thereby increases plasmin activity in keratinocytes.

TXA prevents pigmentation by interrupting the plasminogen that binds to the keratinocyte.

2. Polypodium Leucotomos:

Polypodium leucotomos is a tropical fern. It contains antioxidants that protect the skin from free radical damage.

3. Glutathione:

Glutathione has one of the most powerful antioxidants produced by cells in the human body and is a tripeptide of glutamate, cysteine and glycine. It induces the lightening of the skin by inhibiting the function of tyrosinase.

C. Procedural Treatments

Procedural treatments include chemical peels, laser and light-based treatments, and microneedling.

1. Chemical Peels:

They function by removing the outermost layers of the skin that contain the discoloration. They are frequently used in combination with other topical products.

Glycolic acid is one of the most effective chemical peels. A combination of such chemicals are also being used to treat melasma in recent times.

2. Laser And Light-Based Treatments:

Laser and light-based treatments are the next line of defense after topical therapy or chemical peels.

This treatment is faster as it speeds up the removal of pathways for melanin.

3. Micro-needling:

Micro-needling technique uses fine needles to create many small incisions in the top layers of the skin.

This is a minimally invasive treatment performed by a dermatologist using a derma roller (a small, handheld paint roller coated in tiny needles). It results in cell turnover and gets rid of the pigmented cells.

D. Home Remedies For Melasma

1. Aloe Vera

Aloe Vera contains Aloesin that has inhibitory effects on melanogenesis and tyrosinase activity.

2. Green Tea

Green tea has long been studied for its antioxidant and anti-inflammatory properties. Green tea extracts comprise multiple polyphenolic antioxidants helpful in inhibiting UV-induced melasma.

3. Mulberry

The mulberry extract stops tyrosinase activity, melanin formation in melanocytes and melanin transfer to the upper layers of the skin.

4. Turmeric

The active ingredient of turmeric is curcumin, a yellow pigment. Curcumin stimulates apoptosis (cell death occurs as a normal and controlled part of an organism's growth or development) in human melanoma cells.

5. Soy

Soybean, a legume, consists of many biologically active substances like isoflavones and serine protease inhibitors. It stops the transfer of melanosomes.

Prevention Of Melasma

A. Sunscreen

Use a broad-spectrum sunscreen of at least SPF 30 to keep UV-A and UV-B rays at bay. "Apply sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours," says our in-house dermatologist Dr. Harish Kautam.

B. Sun Protective Clothing, Hat And Sunglasses

Wear sunglasses and a broad brimmed hat that covers your face. "Also, use fabrics for clothing that are sun protective," says Dr. Harish.

C. Avoid Waxing

Waxing may cause skin inflammation which can worsen melasma, so it’s important to avoid waxing areas of the body affected by the condition. Consider using other types of hair removal methods by talking to your dermatologist.

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