What Is Melasma

There are three types of melasma: epidermal, when there is increased melanin (a protein that colours the skin) only in the outer layer of skin; dermal, when there is increased melanin in the deeper layers of skin, and mixed melasma, which is a combination of both. It appears as light to dark brown or greyish patches, and is usually symmetrical (the same on both sides of the face). Melasma doesn’t cause any other symptoms besides skin discoloration but can be very distressing for cosmetic reasons.

What causes melasma?

Melasma seems to occur most often in women of childbearing age who are taking the contraceptive pill, or who are pregnant. It also affects women in the menopausal years that take hormone replacement therapy. This has led to the belief that melasma is caused by increased hormonal levels of oestrogen and progesterone, however this has not been proven. These two predominantly female hormones stimulate melanin production.

There is a correlation of melasma and sun exposure, because melasma occurs most often on the most sun-exposed area (the face); this may explain why men also get it. However, men can also be exposed to larger than normal amounts of oestrogen (see later).

Many melasma sufferers associate the onset of their melasma with a stressful time in their lives. Stress does play a major role in our hormonal system, and chronic stress can lead to hormonal imbalance.

Melasma has also been associated with the use of anti-epileptic drugs, and other prescription drugs such as antibiotics, steroid inhalers, and specialist drugs, although no research has been carried out to date to support this. Medicinal drugs can have a negative effect on the integrity of the gut, which suggests a connection with gut and immune health.

One study of non-pregnant women revealed an association with thyroid autoantibodies, which suggests that thyroid disease may play a role in melasma.

Use of medications such as anti-depressants, thyroid drugs, and drugs to treat ovarian conditions; these can cause photosensitization (hyper-sensitivity to bright light).

A poor diet will inevitably lead to a poor detoxification system, less than optimum immune response, and a body that is out of balance; all of these have been implicated in Melasma.

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