Malsma

Your dermatologist or other healthcare provider will examine your skin to diagnose melasma. They’ll use a Wood’s lamp (a black light) to see changes in the color of your skin. You might have your thyroid checked because there does seem to be an association between thyroid disease and melasma.

Melasma can sometimes be mistaken for another skin condition. To tell the difference between skin conditions, your healthcare provider may perform a biopsy, which is where a small piece of your skin is removed and examined. A biopsy is quick, safe procedure routinely performed during a normal visit to your healthcare provider’s office. Skin conditions commonly confused with melasma include:

Actinic lichen planus and lichen planus.

Drug-induced pigmentation.

Guttate hypomelanosis.

Hydroquinone-induced exogenous ochronosis.

Lentigo (age spots).

Nevus of Hori.

Nevus of Ota.

Postinflammatory pigmentation.

If you have melasma, the results of the biopsy will typically reveal the following:

Dendritic (branched) pigmented melanocytes.

Melanin in the basal and suprabasal keratinocytes.

Melanin in the dermis within melanophages.

Solar elastosis and elastic fiber fragmentation.

Melasma is hard to treat. To determine a treatment plan, your healthcare provider will have to first figure out what’s possibly causing the melasma. Is it sunlight? Your birth control? Genetics? Your soap? Too much screen time?

Depending on the person, melasma may go away on its own, it may be permanent, or it may respond to treatment within a few months. Most cases of melasma will fade away with time and especially with good protection from sunlight and other sources of light.

Unfortunately, there is no definitive treatment that will automatically make melasma disappear. At this time there is no way to remove dermal pigment.

If you have melasma, be sure to avoid:

Hormone treatments, specifically ones that involve estrogen.

Birth control, specifically oral contraceptive pills that contain estrogen and progesterone.

LED light from your television, laptop, cell phone and tablet.

Makeup you find irritating to your skin.

Medications that may cause or worsen melasma.

Scented soaps.

Skin care products that irritate your skin.

Tanning beds.

Waxing, which can aggravate the melasma.