Many people, especially with darker skin types, will notice areas of brown colour on the face. Sometimes this is some pigment following trauma to the face; such as scratches, acne or sun exposure. This is called Post Inflammatory Hyperpigmentation and is discussed elsewhere. (See article on post inflammatory hyperpigmentation)
Some people will experience areas of darker colouration on the face outside of an acne or pimple area. This may be one big area or several small ones. This is called melasma. Melasma is more common in women, as it has a relationship with estrogen, however men can experience it too.
What is melasma?
Melasma describes patches of areas of pigment that arise on the face. They tend to look like darker areas of spots or shades. They tend to occur in women before menopause and moreso in darker skinned women. They are hormonal in origin and tend to be related to estrogen.
How do I treat melasma?
The first step is to reduce the chance of melasma occurring. This includes managing any estrogen imbalances such as difficult periods or estrogen dominance.
Another important thing to do is sun protection. Melasma is made worse by exposure to the sun. Hats and suncream are advised.
Cosmetically, the first line treatment is a pigment inhibitor. This is a cream that reduces pigmentation. An example is hydroquinone. It is applied on the pigmented area for several weeks.
Further treatments involve using laser to break down the pigment. The best type of laser is a Q switch laser. Other types of laser have a risk of traumatising the skin and causing more pigment. It is important to see an experienced laser therapist for your treatment to avoid this.
Finally, patients with melasma should be careful with any cosmetic procedures which involve destroying tissue such as intense ablative laser, facial peels, microneedling or traumatic treatments; this may trigger post inflammatory hyperpigmentation or dark spots on the face if an individual is prone.
Further Reading
- Post inflammatory hyperpigmentation
- Estrogen imbalance
