The never-ending battle between Asians the world over and the sun starts when we’re young. Since we can remember, our mothers have been there with the tubes of SPF 50, T-shirts, and hats to keep the sun’s rays off our skin. We always wondered why and protested vehemently when the sunscreen stung our eyes.
Now, we’re getting on with our lives and those of us that didn’t listen are sometimes faced with pigmentation disorders our 7-year-old selves wouldn’t have even imagined. We all crave glowing, clear skin, but while Asian genes mean aging gracefully, it also means our skin is more prone to scarring, sunspots, and frictional melanosis (pigmentation caused by repeated friction on the skin). Melasma is one of the most commonly occurring pigmentation disorders faced by those of us with Asian skin, read on to learn more about melasma and its treatments.
What Is Melasma?
Melasma is patchy, brown hyperpigmentation on the face and neck (and sometimes the chest and arms) that can be psychologically debilitating. It affects around 40% of women and 20% of men in Southeast Asia. It is more common in females, people with darker skin tones, and it can run in families. Unlike chronic hyperpigmentation from the harsh Australian and New Zealand sun, which appears as random spots or freckles, melasma often appears in symmetrical patterns.
Melasma appears in different areas of the face, including the forehead, eyebrows, cheeks, chin, nasolabial folds, upper lip, earlobes or medial canthal lines. The discolouration can also appear on the lower legs or arms if they are exposed to sunlight for extended periods.
What Causes Melasma?
- Sun exposure: This is the main reason that people develop hyperpigmentation as a result of melanocyte stimulation.
- Melanocytes: The cells in the skin and eyes responsible for producing melanin. High concentrations or hyper-activation creates patches of darker skin.
- Hormonal changes: Melanocytes can misbehave under the presence of hormonal changes or imbalances, including thyroid dysfunction. Similarly, menopause, birth control pills, and cosmetics affecting estrogen and progesterone have been linked to this condition. Genetics play a big role in this as well; of all cases, about 50% of them can be attributed to genetic history.
- Pregnancy: Sometimes called the ‘mask of pregnancy’, melasma can develop due to the hormonal changes brought about by pregnancy.
- Contributing diseases: Hyperpigmentation can be caused by other diseases such as Addison’s, hemochromatosis, and lentigines.
Melasma Treatment
Due to the complexity of its causes, melasma treatments similar to the treatments used for pigmentation problems caused by acne, such as brightening and fading active ingredients, hydroquinone, topical retinoids and chemical peels. In addition, certain in-clinic abrasion, laser, and light therapies have been shown to be safe and effective melasma treatments for Asian skin.
- Microdermabrasion: A mildly abrasive instrument is used to remove the top layer of skin, often used for treating scarring, discolouration, sun damage, and stretch marks.
- Laser Treatment: While laser treatment is appropriate for treating melasma in some cases, it should be used with extreme caution to prevent post-inflammatory pigmentation (a darkening of the skin). When other treatments have not been successful, laser treatment can be considered using very low setting Q-switched Nd:YAG lasers or fractional lasers.
- Chemical Peel: Glycolic peels are commonly used to treat melasma. Azelaic acid reduces melasma in darker skin tones with its anti-melanin properties that act on hyperactive melanocytes.
- Light Therapy: This uses heat from intense-pulsed light (IPL) to remove pigment. However, the heat diffuses to the surrounding tissues, possibly resulting in post-inflammatory hyperpigmentation and a potential relapse within three months. Consult your doctor and dermatologist before taking this route.
- Prescription Only Compounded Creams & Serums: Over the last few years, we have seen more and more telehealth providers creating personalised melasma treatments for patients, like the company Qr8 MediSkin, based on their lifestyles, and current skincare routines. This type of treatment begins with a questionnaire, followed by an online or in-person consultation with a doctor, who will then diagnose your issue based on a complex 3D model of your problem area. A prescription-only cream base or serum is then formulated for your needs and delivered to your door.
The Best Active Ingredients In Melasma Treatments
Hydroquinone: Hydroquinone is used to lighten dark areas of skin, such as freckles, age spots, and melasma, or injury to the skin. Hydroquinone reduces the formation of melanin in the skin.
Tretinoin: Tretinoin is a derivative of vitamin A. It is used on the skin (topically) to treat mild to moderate acne and skin damaged by excessive sun exposure. It increases the rate at which your cells reach maturity and die, therefore quickly replacing the damaged cells with new and healthy ones, free of hyperpigmentation.
Corticosteroids: Some of you may already be familiar with this treatment. Typically, it is used in a variety of ways with the main effect being the reduction of inflammation and immune responses. This is often added to treatment creams to mitigate the more extreme reactions created in the body.
Is There Anything You Can Do To Help Prevent Melasma?
Yes! Sunscreen is one of the most overlooked items in the beauty and skincare industry. For those of us who love spending time outdoors, or even for those who have no choice but to work in the sun, we must remember to protect our skin from the ultra-violet (UV) rays, even though sunshine is necessary for your overall health (vitamin D).
A ‘broad-spectrum’ SPF of 30 and above should be your go-to product, and part of your daily skincare routine. Even if the weather is overcast, put on your sunscreen – UVA light and UVB light cuts through cloud cover, and UBV also penetrates water. There is no one sunscreen on the market that can give you total protection, which is why sunglasses, hats, and protective clothing are often necessary in when the sun is particularly harsh.
To prevent melasma from occurring or reoccurring, we advise that you take extra care when it comes to sun protection, as well as staying away from any sorts of treatments that can cause hormonal imbalances