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Melasma is a common skin problem that causes brown to gray-brown patches on parts of the body that has high exposure to sunlight. The Canadian Dermatology Centre in Toronto is one of the leading dermatology clinics in Canada to expertly manage melasma. Our board-certified dermatologists with a highly trained team of aestheticians will provide a comprehensive assessment of your skin condition and devise a customized treatment approach that is both effective and efficient.

What is Melasma?

Melasma is a chronic skin condition that results in brown to gray-brown pigmentation patches on both sides of the face. The patches are usually symmetrical in nature and can appear on facial areas such as the forehead, cheeks, nose, upper lip and chin. It can also appear on other parts of the body that has high exposure to sun, such as the forearms and neck area. Once it appear, it doesn't spread to other areas of the body and it is not contagious.

The science behind melasma

In our skin we have a type of skin cell that produce melanin called melanocytes. Melanin is a pigment that gives colour to our skin, hair, and eyes. The pigmentation seen in melasma happens when there is an overproduction of melanin by melanocytes, which eventually gets taken up and deposited in the dermis (deeper layer of skin). Sun exposure is one of the most preventable risk factor for melasma because ultraviolet light from the sun can stimulate and increase the production of melanin by melanocytes.

What causes Melasma?

Some of the known triggers for melasma include:

  • Sun exposure and sun damage
  • Hypothyroidism
  • Side effects from oral contraceptive pills and intrauterine devices and implants
  • Hormone treatments
  • Pregnancy

Who gets Melasma?

Although Melasma can appear in anyone, it has the following characteristics:

  • It is more common in women than in men (generally it happens in 1 in 4 women vs 1 in 20 in men)
  • Usually starts between the age of 20 and 40 years
  • More common in people that tan well or have naturally brown complexion (under normal conditions, darker-skinned people have more melanin in their skin than light-skinned people because they have more active melanocytes. The production of melanin is further increased)
  • It has a genetic component (about 33% of those affected have family members affected)

How do we treat Melasma?

At the Canadian Dermatology Centre in Toronto, we use a combination of treatment modalities to effectively manage Melasma. It is important for patients to remember that melasma can be very slow to respond to treatment, especially if it has been present for a long time, and that the main focus is on preventing symptoms of melasma as there is no cure for it.

General preventative measures

  • Discontinute any hormonal contraception
  • Focus on year-round sun protection
  • Use broad spectrum sunscreen with high sun protection factor (SPF 50+)
  • Use a mild cleanser

Topical therapy

There are various topical options available but the key concept is the same - to prevent formation of new pigmentation by inhibiting melanocytes from producing melanin.

  • Hydroquinosone cream or lotion
  • Azelaic acid cream, lotion or gel
  • Kojic acid
  • Cysteamine cream
  • Ascorbic acid
  • Methimazole cream
  • Topical retinoids e.g. tretinoin
  • Topical corticosteroids

What to expect following treatment of melasma?

Although there are a wealth of treatment options available, there is still no cure for melasma. This means that even in patients that responded well to a treatment, the pigmentation may reappear on exposure to sun or due to hormonal factors. This makes the management of melasma very complex and necessitates a comprehensive and professional approach by a board-certified dermatologist, often involving monitoring and management in long-term. Contact our state-of-the-art Toronto clinic today to receive top notch care from our melasma expert dermatologists.

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