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What is melasma?

Often called the mask of pregnancy, melasma is an acquired hyperpigmentation skin disorder that affects up to 20% of pregnant women and almost 10% of women after menopause. 90% of cases appear in women between the ages of 20 and 40. It commonly affects women with darker skin types and those with a blood relative who has melasma. Though less often, it can affect men as well.

Melasma is characterized by irregular flat patches of brown to brown – gray skin discoloration on sun exposed areas of the face specifically the cheeks, forehead, bridge of the nose, chin and above the upper lip, and sometimes on the forearms. Melasma does not cause pain or discomfort but can create concern and impact self-confidence. While there are no symptoms other than its appearance, it is aesthetically displeasing and impacts the quality of life of affected individuals.

Melasma is a chronic recurrent condition that fades when triggers are removed and may fade spontaneously. It is a challenging condition to treat but can be improved and controlled with proper care and treatment.

What causes melasma?

The cause is not known but it develops when the skin color making cells, called melanocytes, produce too much pigment called melanin. Common triggers include sun exposure, visible light, infrared light, heat, female sex hormones and a genetic predisposition.  Pregnancy, hormone replacement therapy and birth control pills and thyroid disease can trigger melasma.

Ultraviolet radiation from the sun, infrared light and visible light stimulate the melanocytes to overproduce melanin creating the characteristic appearance of melasma. Sun exposure worsens melasma and causes it to flare after fading. Other triggers include medications that make the skin sensitive to the sun, and skin care products that irritate the skin including fragrances, can worsen melasma.

Recent research reports that melasma has a more complex cause that makes it difficult to target and likely to recur after treatment. Dr. Michael Sotiriou is a leader in the field of dermatology and understands the evolving nature of melasma. With this knowledge and expertise, he personalizes treatment plans for each of his patient.

How is melasma diagnosed?

During your consultation with Dr. Michael Sotiriou, he will review your medical history and medications, and examine your skin. Because of its classic appearance most cases can be diagnosed by merely looking at skin with out a need for a bioposy. To determine how deeply the skin is discolored may require the use of a device called a Wood’s lamp. A Wood’s lamp is a black light that can reveal changes in skin color. He will also rule out other skin conditions that can resemble melasma and help you identify your triggers.

Melasma is highly challenging to treat due to inconsistent results and frequent relapses. Recent research suggests it is not just a problem with the melanocytes but is also a photoaging skin disorder.

What are the treatment options for Melasma?

Your treatment options will be based on Dr. Sotiriou’s considered medical judgment. Self-care will involve developing a new skin care regime and protecting the skin from the sun; changing birth control to a lower estrogen prescription; avoiding hot yoga and working out in hot humid weather; and choosing fragrance free skin care products and avoiding all identified triggers.

Prescription medications and in office procedures may be beneficial. Topical skin lightening creams such as hydroquinone, may be combined with topical or oral medications including tretinoin (retin-A) and corticosteroids, or another treatment to lighten melasma.

Procedures such as a chemical peel, gentle laser treatments or microdermabrasion may be considered. Regardless of the treatment, in order to minimize the risk of recurrence , it is important to minimize sun exposure and use a blocking sun screen that contains zinc oxide or titanium dioxide first thing every morning.

Under his treatment, you can have confidence that Dr. Michael Sotiriou will devote his best efforts to help you achieve the desired improvements and will create a maintenance plan to sustain those results.

Contact him at Salt Lake Dermatology & Aesthetics in Salt Lake City Utah to schedule a consultation to receive the correct diagnosis and learn about your treatment options.

At a Glance

Dr. Michael Sotiriou

  • Board-certified, Residency-Trained Medical and Cosmetic Dermatologist
  • Sub-Specialty Board Certification in Mohs Micrographic Dermatologic Surgery from the American Board of Dermatology
  • Fellow of the American Academy of Dermatology
  • Learn more

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