What is Melasma
Melasma is a common skin condition that causes dark, discoloured patches or hyperpigmentation on the skin, typically on the face. It predominantly affects women, although men can also develop it. The condition is more common in individuals with darker skin tones, such as Kenyans, Africans at large, Asians, or Hispanic descent.
Commonly Affected Areas by Melasma
Melasma commonly affects areas of the face that are exposed to sunlight. The most frequently affected areas include:
- Forehead: The central part of the forehead, along with the hairline, is a common site for melasma patches to appear.
- Cheeks: Melasma patches can occur on the cheeks, usually in a symmetrical pattern on both sides of the face.
- Nose: The bridge and sides of the nose can be affected by melasma, often appearing as irregular patches or spots.
- Upper Lip: Melasma can manifest as dark patches on the upper lip, known as the “mustache area” or “upper lip mask.”
- Chin: The chin may develop melasma patches, usually symmetrically on both sides.
It’s important to note that melasma can also occur on other areas of the body that are exposed to sunlight, although it is less common. These areas may include the neck, arms, and chest.
The distribution of melasma can vary among individuals, and the affected areas may differ in intensity and size. The patches are typically symmetrically distributed, meaning they appear on both sides of the face or corresponding areas of the body.
If you notice any changes in your skin, such as the appearance of dark patches or hyperpigmentation, it’s advisable to consult with a dermatologist or healthcare professional for an accurate diagnosis and appropriate treatment options.
What are the common causes of Melasma
Melasma can have several contributing factors, but the exact cause is not fully understood. The common causes or triggers of melasma include:
- Hormonal Factors: Hormonal changes play a significant role in melasma development. Fluctuations in hormone levels, particularly estrogen and progesterone, can trigger or worsen melasma. This is why melasma is more common in women, especially during pregnancy (chloasma or “the mask of pregnancy”) and hormonal contraceptive use. Hormone replacement therapy (HRT) and certain medications may also contribute to melasma.
- Sun Exposure: Ultraviolet (UV) radiation from the sun is a major trigger for melasma. Sun exposure stimulates the production of melanin, leading to the development of dark patches. The condition often worsens in the sunny months in Kenya or intense sunlight. Lack of proper sun protection, such as not using sunscreen or protective clothing, can exacerbate melasma.
- Genetic Predisposition: There may be a genetic component to melasma, as it often runs in families. Having a family history of melasma increases the likelihood of developing the condition.
- Ethnicity and Skin Type: Melasma is more common in individuals with darker skin tones, such as Kenyans, Africans in general, Asians, Hispanic, or Middle Eastern descent. People with Fitzpatrick skin types III to VI (darker skin tones) are more susceptible to melasma due to the presence of more active melanocytes, the cells responsible for producing melanin.
- Other Factors: Certain medications, such as hormonal treatments, anti-seizure medications (e.g., phenytoin), and some cosmetics or toiletries containing fragrances or irritating chemicals, may contribute to melasma development or exacerbation in susceptible individuals. Other potential triggers include heat, excessive sweating, and certain skin care products.
Types of Melasma
Melasma is typically classified into different types based on the depth of pigmentation in the skin. The classification is as follows:
- Epidermal Melasma: This type of melasma affects the top layer of the skin, known as the epidermis. The excess melanin pigment is concentrated in the epidermal layer, leading to dark patches. Epidermal melasma appears as brownish or tan patches and is usually well-defined. It tends to respond well to treatment and is generally more superficial compared to other types.
- Dermal Melasma: Dermal melasma involves pigmentation in the deeper layer of the skin called the dermis. The excess melanin is located deeper within the skin, making it more challenging to treat. Dermal melasma appears bluish-gray or slate-coloured patches, and the borders may be less defined than epidermal melasma. Dermal melasma often requires more aggressive treatment approaches and may be less responsive to topical treatments alone.
- Mixed Melasma: Mixed melasma is a combination of both epidermal and dermal melasma. It involves pigmentation in both the epidermis and dermis. Mixed melasma presents with patches that have varying shades and depths of colour. It can be more challenging to treat due to the involvement of multiple layers of the skin.
How Treat Melasma, Dark Patches on the Face in Kenya
Treating melasma and dark patches on the face requires a comprehensive approach that includes a combination of topical treatments, lifestyle modifications, and sun protection. Here are some common treatment options for melasma in Kenya:
- Sun Protection: Protecting your skin from the sun is crucial in managing melasma. Use a broad-spectrum sunscreen with a high SPF (30 or above) daily, even on cloudy days. Reapply sunscreen every two hours, especially if you are outdoors. Wear a wide-brimmed hat, sunglasses, and protective clothing to minimize sun exposure.
- Topical Creams and Serums: Our Dermatologists often prescribe topical treatments that target pigmentation and help lighten the dark patches. These may include:
- Hydroquinone: A skin-lightening agent that reduces melanin production.
- Tretinoin: A vitamin A derivative that helps exfoliate and lighten the skin.
- Corticosteroids: These can help reduce inflammation and lighten the pigmentation.
- Azelaic acid: It helps regulate melanin production and has anti-inflammatory properties. These topical treatments are usually applied once daily and should be used under the guidance of a healthcare professional.
Melasma Treatment Procedures at Afyacore Aesthetics Clinic in Nairobi, Kenya
- Chemical Peels: Chemical peels involve applying a chemical solution to the skin to exfoliate the top layers and improve skin tone. Superficial or medium-depth peels containing ingredients like glycolic acid, salicylic acid, or TCA (trichloroacetic acid) can be used to treat melasma. Multiple sessions may be required to achieve desired results.
- Laser Therapy: Laser treatments can target and break up excess melanin in the skin. Different types of lasers, such as Q-switched lasers or fractional lasers, may be used for melasma treatment. Laser therapy typically requires multiple sessions. Therefore, it’s important to protect the skin from sun exposure before and after the procedure.
- Microdermabrasion: This procedure involves exfoliating the skin using a device that sprays tiny crystals or uses a diamond-tipped wand to remove the outer layer of skin cells. Microdermabrasion can help improve skin texture and reduce pigmentation. Multiple sessions may be needed to achieve the desired results.
- Combination Therapy: In some cases, a combination of treatments may be recommended to address melasma effectively. This can include a combination of topical creams, chemical peels, and laser treatments for more stubborn or deep-seated melasma.