Understanding Melasma: A Guide to This Common Skin Discoloration

“True” brown spots are harmless. But our team at Aviva Dermatology understands that such hyperpigmentation may still be bothersome and detract from your youthful, radiant appearance. Melasma is characterized by dark discoloration. It can be stubborn, but our dermatologists in Houston, Texas, Drs Simone Stalling MD, PhD, FAAD, and Rosannah Velasquez, MD, work with patients to prevent their melasma from getting worse and to fade existing patches.

What is melasma?

Melasma is a common type of skin discoloration. While it is not dangerous, melasma may still require treatment, as the patches or spots tend to be very noticeable. Their appearance can also vary depending on your skin tone. For some people, melasma can look light or dark brown, whereas, for others, their patches may appear blue or even gray.

Why am I developing melasma?

Hormones are associated with melasma. In fact, this condition is often called “the mask of pregnancy” because it affects at least 15% of pregnant women. It typically affects women during their reproductive years, and other risk factors include the use of birth control and hormone replacement therapy that contains estrogen and progesterone. Additionally, melasma is associated with UV radiation/sun exposure. It is no surprise that these patches are most prevalent on sun-exposed skin and areas such as the forehead, cheeks, nose, upper lip jawline, neck, shoulders, and upper arms. There also appears to be a loose association between thyroid disease and melasma. 

How do I know if it’s melasma or something else?

Knowing for sure what is affecting the appearance of your skin and, in turn, how to treat it requires professional expertise and care. During an evaluation, Drs Stalling or Velasquez will closely examine your discoloration. We will also review your medical history and may perform a biopsy. This service involves removing a small sample of tissue in the affected area. This tissue is then analyzed to rule out other conditions, such as skin cancer, and to confirm a diagnosis – the first step to effective treatment.

What are some ways that AVIVA Dermatology treats melasma?

For starters, know that melasma is a chronic condition without a cure.  Certain risk factors like reducing exposure to sunlight and tannin should be avoided. Be aware that some patients’ skin responds faster to treatments than others. It is important to exercise patience because melasma can be incredibly stubborn. The deeper the melasma or pigment is in the skin, the harder it is to treat. For instance, epidermal melasma is more superficial, generally appears well-defined and dark brown, and responds relatively well to treatment compared to deeper dermal melasma that appear light brown or blueish and do not have clear borders. 

Depending on these and other factors, our dermatologists in Houston, TX, may prescribe medicated creams, oral drugs, or retinoids such as tretinoin. Some of these medications may be combined. In-office therapies such as chemical peels or injections may be appropriate, too. Call (713) 468-0303 to schedule your consultation today.