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What is hyperpigmentation?

Hyperpigmentation is a condition in which patches of skin become darker in color than the normal surrounding skin. This darkening occurs when an excess of melanin, the brown pigment that produces normal skin color, forms deposits in the skin. While technically harmless and treatable, it can be unsightly with issues like sun spots, age spots, melasma and freckles. Treatment is available for those who choose to remove them.

Did you know?

All melasma is hyperpigmentation, but not all hyperpigmentation is melasma.

Melasma and pigmentation are two different skin conditions.

Melasma is a common skin problem that causes brown or gray-brown patches on the face, particularly the forehead, cheeks, nose and upper lip. It can also appear on sun-exposed areas like the neck and forearms. Melasma can be due to hormonal changes during pregnancy, sun exposure, etc. 

Pigmentation is the process of changing skin color due to the overproduction of melanin.

Melasma: A persistent and vexing condition

Although melasma does not cause physical pain or pose any health dangers, it can provoke intense emotional distress in individuals who experience the emergence of these dark spots on their skin. Treating the condition can pose challenges, with plenty of false information circulating about its origins.

What causes melasma?

  • Sun exposure: Frequent exposure to UV rays can trigger melasma
  • Skin color: Melasma occurs most commonly in people with light brown skin tones, particularly if they live in areas with high levels of sun exposure
  • Female sex: Melasma affects females about 9 times more than it does males
  • Pregnancy: Melasma is more common during pregnancy, affecting 15% to 50% of pregnant women. This may be due to pregnancy hormones
  • Genetics: Up to 50% of people with melasma report that close relatives also have the condition

Potential triggers for melasma can include:

  • Changes in hormones during pregnancy (chloasma)
  • Hormone treatment or taking birth control pills
  • Sun exposure
  • Certain skin care products, if they irritate a person’s skin
  • Some medications, including anti-seizure medications and those that make the skin more sensitive to sun exposure, such as includes retinoids, some blood pressure medications and certain antibiotics

Melasma is more common in women

Melasma is commonly known as the “mask of pregnancy” as it can be caused by elevated hormone levels in pregnant females. However, while the issue is frequently seen in pregnant females, it’s not exclusive to them.

It’s not just linked to pregnancy, but can also impact women of every age.

Women who develop melasma in their teens or 20s or 30s may see it stay around for decades.

What are the symptoms of melasma?

The signs of melasma are very noticeable. It causes light brown, dark brown, and/or bluish patches or freckle-like spots on your skin. The patches might also be red or inflamed. Melasma commonly shows up in 6 places or a combination of sites on your skin:

  • Brachial: On your shoulders and upper arms 
  • Centrofacial: Forehead, cheeks, nose and upper lip 
  • Lateral cheek pattern: Both cheeks 
  • Malar: Cheeks and nose 
  • Mandibular: On your jawline 
  • Neck: In people over the age of 50, melasma on all sides of the neck 

You may see it show up on your cheeks, nose, chin, above your upper lip or on your forehead. Sometimes you can see it in other places like your arms, neck or back. 

While it is more common in these areas, melasma can show up anywhere on the body that is exposed to the sun.

This is why symptoms can increase during the summer. 

What are the different types of melasma?

Melasma presents in one of three ways. The type has to do with the darkness of the color, the shape of the border, and how well it responds to treatment. A black light is used to test this. 

Type 1: Epidermal melasma. 

This affects the top layer of your skin, known as the epidermis. Usually the patches appear on your face and are dark brown in color and the shape is relatively uniform.

Type 2: Dermal melasma. 

This type of melasma acts on the deeper layer of your skin called the dermis. It’s usually bluish gray or grayish brown and it has a blurry border. Because this melasma is deeper in the skin, your dermatologist may use treatments such as laser therapy or microneedling. 

Type 3: Mixed melasma. 

This is the most common type of melasma. It’s a combination of epidermal and dermal melasma. The patches can appear as a mixture of brown, gray and bluish gray colors. Your dermatologist may use a combination of treatments, including topical creams, chemical peels, laser therapy and microneedling.

Is melasma a type of cancer?

No, melasma is not a type of cancer. 

It’s also not a sign of skin cancer. Melasma differs from skin cancer in that it typically feels flat and appears on both sides of your face.

What are the treatment options for melasma?

Melasma is a skin condition that can be triggered by sunlight, birth control pills and stress. 

To treat melasma, a dermatologist will create a personalized treatment plan based on your skin tone, the depth of the pigmentation and any triggers you may have. 

  • The goals of treatment are to:
    1. reduce pigment production, and 
    2. even out your skin tone 

The treatment plan often includes sun protection measures, medication and procedures.

  • Common medications for melasma include hydroquinone, tretinoin, corticosteroids and combination creams 
  • Other options may include kojic acid or vitamin C. In some cases, additional treatments like chemical peels, microneedling, laser therapy or platelet-rich plasma injections may be recommended to improve results
  • For stubborn cases of melasma, tranexamic acid may be prescribed to help decrease pigmentation. It can be applied topically or taken orally

Despite treatment, some individuals may still experience melasma, prompting ongoing research into new therapies and approaches.

Challenges in treating melasma

Melasma treatment can be challenging, with spots often not fully cleared and recurrences being common. 

A significant challenge in treating melasma is the low permeability of water-soluble substances through the hydrophobic layer of the stratum corneum.

  • In severe cases, oral drugs like tranexamic acid may be prescribed, but caution is needed due to its thrombophilic nature 
  • Procedures such as microneedling and chemical peels can complement topical treatments, though lasers should be used carefully to avoid post-inflammatory melanogenesis
  • Combining topical agents, oral medications and procedures can yield faster results, but further research is needed on preventing relapses

A new secret to fading dark spots and treat melasma

Cetyl Tranexamate Mesylate, a pioneering depigmentation agent, promotes a naturally uniform skin tone.

  • Evidence suggests, it’s safe for skin and poses no adverse skin reactions of any intensity such as:
    1. Dryness
    2. Scaling
    3. Stinging
    4. Papules
    5. Edema
    6. Vesicles

Cetyl Tranexamate Mesylate (CTM) presents a higher level of skin targeting and could potentially be more efficient.

In a research, using a cream that contained cetyl tranexamate mesylate for 2 weeks resulted in a notable decrease in skin pigmentation.

Patients greatly affirmed a noticeable improvement after 2 weeks of utilization;

  • 79.3% of patients saw a boost in skin tone
  • 78.6% of patients saw a decrease in dark spots
  • 77.1% of patients experienced a reduction in facial redness
  • 80% of patients experienced improved skin clarity
  • 80% of patients experienced an improvement in brightness of complexion  

Cetyl tranexamate mesylate offers a two-fold advantage by reducing both facial dark spots and redness at the same time.

A new secret to fading dark spots and treat melasma

Melasma Self-care Guidelines

  • Protect your skin from sun exposure to prevent worsening of melasma  
  • Use sunscreen with SPF 30 or higher, covering all exposed skin, including lips
  • Avoid spray sunscreens and opt for lotion or cream sunscreen
  • Tinted sunscreens offer extra protection
  • Skin is sensitive to UV light year-round, so sunscreen is essential
  • Cover-up makeups like Dermablend can help conceal melasma

References:

  1. Available from: https://www.aocd.org/page/Hyperpigmentation. Accessed on September 25, 2024.
  2. Available from: https://www.flawlessaestheticcenter.com/blog/hyperpigmentation/. Accessed on September 23, 2024.
  3. Available from: https://www.clearskin.in/blog/differences-between-melasma-and-hyperpigmentation/. Accessed on September 23, 2024.
  4. Available from: https://www.health.harvard.edu/womens-health/unmasking-the-causes-and-treatments-of-melasma. Accessed on September 23, 2024.
  5. Available from: https://www.medicalnewstoday.com/articles/323715#diagnosis. Accessed on September 23, 2024.
  6. Available from: https://www.webmd.com/skin-problems-and-treatments/what-is-melasma. Accessed on September 23, 2024.
  7. Available from: https://www.aad.org/public/diseases/a-z/melasma-overview. Accessed on September 23, 2024.
  8. Available from: https://www.aad.org/public/diseases/a-z/melasma-treatment. Accessed on September 25, 2024.
  9. Cassiano DP, Espósito ACC, da Silva DN, et al. Update on Melasma—Part II: Treatment. Dermatol Ther (Heidelb). 2022;12(9):1989–2012.
  10. Available from: https://sophixnatural.com/product/cetyl-tranexamate-hcl-txc/. Accessed on July 19, 2024.
  11. Souza IDDS, Lampe L and Winn D. New topical tranexamic acid derivative for the improvement of hyperpigmentation and inflammation in the sun-damaged skin. J Cosmet Dermatol. 2020;00:1–5.
  12. Available from: https://ctv.veeva.com/study/the-effects-of-cetyl-tranexamate-mesylate-on-the-appearance-of-acne-related-hyperpigmentation. Accessed on July 24, 2024.
  13. Available from: https://skinsight.com/skin-conditions/melasma. Accessed on September 23, 2024.