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Melasma.Causes and treatment of melasma

What is melasma

Human skin acquires its color through the melanin pigment secreted by melanocytes located in large numbers inside the epidermis, and these cells are more active in dark-skinned people, and this pigment protects the skin from the harmful effects of ultraviolet rays in the sun, so this pigment plays the biggest role in the occurrence of skin pigmentation disorders, such as melasma, freckles, and others.

Melasma.Causes and treatment of melasma

In this article, we discuss in detail the causes of the appearance of melasma, its types, methods of treatment, and the most important tips to reduce it.

Causes of the appearance of melasma

The exact cause of the appearance of melasma remains unknown to this day, and the mechanism of its formation is likely due to the hyperactivity of melanocytes present in the epidermis and their production of excessive amounts of melanin pigment, which may explain its prevalence in dark-skinned races more than others.

Studies have proven the existence of several factors that increase the appearance of melasma, the most important of which are the following: 

Exposure to sunlight

Frequent exposure to sunlight is the most important factor for the appearance of melasma, as the ultraviolet rays contained in sunlight stimulate melanocytes and activate their work, and this explains the reappearance of melasma in those who have previously suffered from it after exposure to sunlight in the summer, especially.

Changing the level of hormones

The relationship between chloasma and some hormones is still not fully understood, and perhaps the best example of chloasma caused by hormonal changes in pregnancy is chloasma, or what is known as the pregnancy mask.

In addition, birth control pills and taking compensatory hormonal treatments that are prescribed to some women during menopause may worsen the condition of melasma.

Skincare products

Skincare products, especially those that contain fragrances such as skin moisturizers and some skin-washing solutions, can irritate, and therefore may worsen the condition of existing melasma.

Genetic factors

Some recent studies have proven that people who have relatives with melasma have a higher chance of developing melasma after constant exposure to sunlight or taking oral contraceptives.

Stress injury

Exposure to severe anxiety and stress may increase the likelihood of melasma on the skin in some people.

Thyroid problems

The occurrence of some thyroid problems related to its increased activity or insufficiency is one of the most important factors that lead to the appearance of melasma on the skin.

Types of melasma

The face and upper neck area are the most places where melasma appears, the rest of the body areas are rarely affected, such as the arms, back, and abdomen melasma of the face is divided according to its location into three types, which are as follows: 

Mid-face melasma is the most widespread pattern, in which melasma appears on the forehead, cheeks, upper lip, nose, and chin.

Lateral melasma Or melasma on both sides of the cheek, which is distributed only on the cheeks.

Melasma on the jaw: in this case, melasma appears around the jaw area.

Melasma can also be divided according to the location of pigmentation within the layers of the skin into three different patterns, which are as follows: 

Epidermal Melasma

It is in it that the melanin pigment in this pattern is found in the surface layers of the epidermis, which is the least intense among the other patterns.

Dermal Melasma

It is where melanin is found within the deeper layers of the epidermis, which is the most difficult to treat.

Mixed Melasma

This pattern combines the two previous patterns, as the melanin pigment is distributed between the different layers of the epidermis.

Methods of treatment of melasma

Some cases of melasma may not need any treatment, such as gestational melasma, which may regress on its own after childbirth, but for the rest of the cases, either the treatment leads to the final removal of the spots or lightening their color and size and preventing the appearance of new spots, and these treatments include the following:


People who suffer from melasma or are susceptible due to the genetic factor of infection are advised to put the sunblock on when going out during the day permanently and renew it two hours after putting it on.


Hydroquinone is considered the first pharmaceutical option for the treatment of melasma, as it works to gradually lighten the skin color, including melasma areas, by affecting the melanin-producing parts inside the melanocytes.


This drug also lightens the skin color and pigmented areas, and the doctor may prescribe it as a monotherapy in mild cases of melasma or in combination with hydroquinone in one preparation, to increase its effectiveness when treating more severe cases, and the side effects of these drugs are limited to dry skin and sometimes slightly irritated.


Steroids are used in combination with the previous drugs in combined ointments, and this is known as the triple treatment of melasma (hydroquinone, tretinoin, and steroid), and these drugs are combined into one ointment in different proportions depending on the severity of the case, and this treatment has proven effective in the majority of melasma patients.

Chemical peels and laser peels

In case of dissatisfaction with the results obtained by the patient from the initial drug treatment, it is possible to resort to chemical peeling or peeling with laser devices to remove thin layers of superficial skin, but taking into account the specificity of each case, as laser rays can worsen some types of melasma instead of curing it.

Daily tips to reduce melasma spots

Here are the most important daily tips that you can follow to deal with melasma spots that appear in unwanted places: 

Natural remedies and masks

The most famous of them are lemon juice, parsley extract, sour milk, vinegar, and aloe vera gel, as these natural substances are known for their ability to filter the skin, even out its color, and exfoliate gently, but you should pay attention not to put them on the skin for long periods, so as not to cause allergies or some unpleasant redness.

Food rich in vitamins

When talking about the relationship of vitamins to the appearance of the skin, the first thing that comes to mind among the vitamins is vitamin E, due to its important role in renewing the layers of the skin and giving it a fresh appearance.

Therefore, melasma patients are advised to eat foods rich in vitamin E, such as spinach, nuts, etc., or even buy them in the form of capsules at the pharmacy and take them as dietary supplements.

Sun protection

Sun block should be put on daily and continuously even on non-sunny days, in addition to wearing wide-brimmed hats and sunglasses.

Even though melasma spots do not pose a real danger to skin health, they are often an unpleasant and alarming problem for their owner, making him unsure of his appearance and uncomfortable with the color of his skin.

With the progress of Medicine in the fields of Cosmetology, there are fewer cases of melasma in which doctors are unable to provide satisfactory aesthetic solutions, but prevention remains better than any treatment, so it is necessary to pay close attention to the sun's rays and protect our skin from them.

And this is not only to prevent the appearance of melasma but to avoid many health problems, which may be caused by excessive exposure to it, perhaps the most dangerous of which is skin cancer.


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