Melasma is a common skin disorder that causes brown to gray-brown patches and pigmentation on the face. It can also affect the back, arms, neck and other parts of the body which gets a lot of sun exposure. Most people get it on their cheeks, upper lip, forehead,  bridge of their nose, chin, etc. It is important to not confuse Melasma with Hyperpigmentation.

Who Gets Melasma?

Melasma is more common in women than in Men, in dark skinned patients and can happen to anyone between the age of 20-40 years.

What Triggers Melasma?

The pigmentation is caused due to overproduction of melanin by the pigment cells triggered by causes like:

• Hormonal changes

• Severe temperature changes along with Sun exposure

• Hereditary 

• Pregnancy

• Hypothyroidism

• Oral contraceptive pills

 

How To Diagnose And Treat Melasma?

Diagnosis of Melasma is simple and mostly clinical. However, the treatment differs based on different causes and type of Melasma. Epidermal melasma responds faster than dermal melasma. The depth of melasma can be better understood using Wood’s Lamp. In some cases, your dermatologist may remove a part of your skin to run a biopsy. 

Depending on the exact cause, the best treatment for Melasma include:

• A chemical peel, 

• microdermabrasion, or 

• laser toning

While these treatments are known to be most successful, it is strongly advised that they are performed by a dermatologist and after a consultation only.

The objective of the Melasma treatment on face is to reduce and ultimately stop melanocytes from producing any new pigments. Azelaic acid and Kojic acid are  commonly recommended  Melasma treatment by dermatologists in India.

Devices Used By Dermatologists:

Q-switched Nd:YAG lasers are most commonly used by the dermatologists. Laser Toning is a commonly performed treatment in melasma which uses very low fluence to disrupt and destroy the melanocytes. This procedure is safe and effective in treatment of melasma.

Precautions:

• If you are taking any medication causing hormonal upheavals, discontinue them. 

• Make sure you protect your face from the sun, don’t forget to wear a hat. 

• No matter what the weather, wear sunscreen with a broad spectrum of at least SPF 30 or more.

• Do not use harsh cleansers for face

• Avoid the skin products that can irritate the skin further

• Take good care of your skin on a regular basis

• Avoid preparations containing steroids and hydroquinone for a long period of time as they can cause side effects.

Post-treatment care: Consult your doctor if you face skin irritation, darkening of the skin or any other complications.

When can you see the results of Melasma treatment?

It takes several months to see substantial improvement post the treatment. It is very important to follow the guidelines of your dermatologist to reduce the recurrence of Melasma. 

Consult Dr. Rakhavi Midhun to understand how your Melasma can be treated today.

 

What Are White Patches?
White patches, also known clinically as Vitiligo, is the result of lacking melanin in the skin. Melanin is the protein present in the skin cells (Melanocytes) that gives every individual their respective skin color. When the affliction to vitiligo is observed, the general conclusion is that there are not enough working melanocytes to produce enough melanin in the skin. This causes white patches to appear and seemingly spread or grow across the skin and even sometimes hair.

This is a skin condition that has led to the stigmatization of an individual’s appearance, which is responsible for a gross marginalization of people with the condition. This leads to insecurities about their appearance due to their ill treatment in society.

Types Of Vitiligo:

1. Focal Vitiligo: Where the white patches are clustered in one area, such as arms legs, back or face.

2. Generalized Vitiligo: Where the individual has white patches all over the body and usually affects them in a symmetrical pattern. This is the most common type of Vitiligo.

3. Segmental Vitiligo: Where the individual has vitiligo patches on only one area of the body. Least common type.

What Causes Vitiligo ?
As stated above, the main cause for vitiligo is the low performance of melanocytes in the skin. Though there is no discernible evidence as to what exactly causes vitiligo, the theory that autoimmune disorders are partly responsible gains merit under the assumption that the immune system attacks the healthy skin cells resulting in melanin reduction. Many researchers believe that it is also a genetic condition. 

However there are many factors that could possibly trigger the failure of melanocytes. One possible condition is related to a history of Autoimmune disorders. It can also happen anywhere on the body and usually appears in areas with heavy sun exposure. 

It is also largely  believed that Vitiligo is triggered by stressful events, severe skin damage due to sun burns, chemical burns, cuts, etc. It is also heavily misunderstood as being contagious. You cannot contract Vitiligo from an individual who has it, neither is it caused by any bateria, virus or infection.

What Are The Risk Factors Or Complications Due To Vitiligo ?
Vitiligo can usually lead to vulnerabilities in the skin and increase the susceptibility to skin conditions more. Due to decreased melanin, people with vitiligo are more prone to skin cancers and sunburns due to minor exposures to sun.

There is also some evidence that suggests the linking of eye and ear problems, such as iris inflammation, inflammation of the middle layer of the eye and even partial loss of hearing.

What Is The Possible Treatment?
Though there is no cure for Vitiligo, there are treatment options to reduce their appearance. For example, a skin camouflage, with appropriate cosmetic merit can be used to cover up small and visible spots. Some mild steroid creams are available that can restore a certain amount of colour to the skin, but can have severe side effects such as sagging, stretch marks, skin thinning, etc. In some cases, phototherapy may be used to restore skin color, however they are not very effective and are costly. Treatment is not known to stop the spreading of this condition. 

The most effective coping mechanism comes from dealing with the social stigma and self esteem issues caused by it, which can be handled with the help of support groups and mental health specialists. Creating awareness about Vitiligo must be the first step to understanding and removing the misconceptions and misunderstandings.