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What is melasma?

Melasma is a common hyperpigmentation disorder. It affects about 30% of child-bearing women of Latin and Asian descent who have a blood relative with melasma. It also affects women who take oral contraceptives and use hormone therapy. While it doesn’t cause any symptoms, many women find it significantly impacts their psychological, social and emotional wellbeing, and reduces their confidence and quality of life.

Melasma is a chronic condition and while it may fade spontaneously, it is likely to remain a problem that can be controlled with proper care and treatment. The best prevention is to avoid sun exposure and receive a life plan for your skin.

This skin condition is characterized by symmetrical light to dark brown or gray-brown patches on the face, typically on the cheeks, forehead, nose, and upper lip.

The exact cause of melasma is not known, but it is related to hormonal changes, particularly during pregnancy or while taking birth control pills, sun exposure, some medications, stress, tanning bed use and thyroid disease which can trigger the body to produce excess melanin, the substance that gives the skin its color. 50% of women with melasma have a positive family history of the condition.

At your dermatology consultation, Dr. Shagalov will review your medical history and the medications you take and visually inspect your skin. She may use a Wood’s lamp which is a device to help her better examine your skin. She may also take a skin biopsy to rule out other causes of hyperpigmentation. From this information she will provide her diagnosis and a treatment plan based on your concerns, and your needs.

Sometimes melasma can go away without treatment especially if you have the baby or stop using birth control pills or other triggering medications and protect your skin from the sun.   Other times it can last for years. Melasma is a chronic disorder. Early treatment can help fade the discolorations but does not prevent a recurrent outbreak.

Treatment for melasma typically includes a combination of topical creams, chemical peels, and protection from the sun. Hydroquinone, a skin-lightening agent, is often used to lighten the affected areas. Tretinoin and corticosteroids may also be used to help reduce pigmentation.

It’s important to protect the skin from the sun to prevent melasma from getting worse, and to use sunscreen with a sun protection factor (SPF) of at least 30 every day. Sunscreen should be reapplied every two hours, or more often if you are swimming or sweating.

In more severe cases, procedures such as microneedling with or without PRP, microneedling with topical tranexamic acid or specialized laser therapy may help lighten the affected areas. In the most severe cases, oral medication with Tranexamic acid can be used to treat melasma.

Melasma can be a stubborn condition to treat, and it may take several months to see improvement. If you think you may have melasma, it’s important to schedule a consultation with Dr. Devorah Shagalov at her Miami office to receive accurate diagnosis and treatment plan. Dr. Shagalov is a board-certified dermatologist and a dual fellowship trained Mohs Surgeon and cosmetic dermatologist. Biscayne Dermatology is located in Midtown Miami on the border of Edgewater and Wynwood a few blocks from the Design District, Miami Beach, and Downtown Miami.

At a Glance

Dr. Devorah Shagalov

  • Double Board-Certified Dermatologist
  • Fellowship-Trained Mohs Micrographic Surgeon
  • Recipient of numerous dermatology awards
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