Patient Education and Counselling:
Melasma Understanding: Melasma, also called ‘chloasma’, is a common skin condition of adults in which light to dark brown or greyish pigmentation develops, mainly on the face. Although it can affect both genders and any race, it is more common in women and people with darker skin-types who live in sunny climates. Melasma usually becomes more noticeable in the summer and improves during the winter months. It is not an infection, it is not contagious and it is not due to an allergy. Also, it is not cancerous and will not change into skin cancer.
This is a chronic skin condition, which can be treated but is prone to relapsing without correct care.
The first step in treating melasma is confirming with a dermatologist that your darkened skin patches are indeed melasma, and determining what’s causing it. Treating melasma is unlikely to be effective if the underlying cause isn’t addressed. If you’re still being exposed to exacerbating factors, you could just be on a hamster wheel, running and not getting better even whilst treating the melasma.
Trigger Identification and Avoidance: Please see below the common trigger points for melasma and our recommendation.
Sun and Heat Exposure: A big trigger for melasma getting worse is sun and heat exposure, this includes anything from sunny places to tanning beds. Melasma can be caused or worsened by not only the sun’s rays, but also heat and visible light.
We recommend a zinc-based SPF reapplying throughout the day, avoiding sitting in direct sun for long periods of time. However, this alone will not be enough to protect the skin completely to ward off melasma.
Hormonal Factors: If a hormonal contraceptive is causing the problem, a woman might consider switching to a nonhormonal option, such as a copper intrauterine device.
Medications: We must review any current medications for photosensitising agents.
Irritants: We advise against irritating skincare products, harsh chemicals, and excessive friction (e.g., certain hair removal methods).
Stress: Try to keep stress levels controlled. A big flux in this can cause melasma to alter.
Importance of Adherence: Stress that consistent daily adherence to the protocol is critical for achieving and maintaining results.
Foundational Skincare and Sun Protection (Daily, Year-Round):
Sunscreen: We highly recommend a broad-spectrum, water-resistant sunscreen with SPF 30 or higher, with a high UVA rating (4/5 stars). Recommend tinted mineral sunscreens containing zinc oxide for enhanced protection against visible light, especially for darker skin tones. Apply liberally (approximately one teaspoon for face and neck) 15–30 minutes before sun exposure and reapply every 2 hours or immediately after swimming or sweating.
Physical Protection: Advice on seeking shade, wearing wide-brimmed hats, and UV-protective clothing.
Gentle Skincare: We recommend gentle, fragrance-free cleansers and moisturisers to maintain the skin barrier function and reduce irritation, which can exacerbate melasma.
Establish a good cleansing regimen. Environmental pollution can contribute to melasma. Airborne pollutants can bind to the skin and corrode the protective surface, making it weaker and more susceptible to sun damage. Clean your skin every night before bed with a cleanser that can thoroughly remove particulate matter and help protect the skin, she says.
Vitamins C and E can help heal damage from sunlight. So, dab on a few drops of a serum that contains these vitamins to improve skin health and ward off the harmful effects of sun exposure and seal with a fragrance free moisturiser. However, if you have active acne, we do not recommend using vitamin C!
