Melasma: Can skin doctors help treat them?


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Melasma is a skin pigmentation disorder causing brown or grey patches on your skin. Some patients Melasma is a skin pigmentation disorder causing brown or grey patches on your skin. Some patients might experience chronic melasma that lasts for years or their whole lives. On the other hand, it might be temporary for some patients, such as during pregnancy. Usually, people who receive excess sun exposure can develop this skin condition.

Besides, women can develop brown patches on their facial skin, especially on the forehead, nose bridge, and cheeks. Your skin doctor Johor Bahru might prescribe topical medications or apply various medical procedures to treat your symptoms. This blog will discuss the various medical treatment methods that skin doctors might suggest to treat melasma.

Types of Melasma

The types of melasma depend on the depth of the pigment. Your dermatologist might use a Wood’s lamp or dermatoscope to identify how deep pigments have reached your skin layers. The following are the three types of melasma that individuals might develop.

  • Epidermal – It causes dark brown patches with a well-defined border. They are more prominent under black light.
  • Dermal – They are light brown or bluish and have a blurry border. This type of melasma appears no different under a black light.
  • Mixed melasma – They can be both bluish and brown patches and is visible in a mixed pattern under black light.

Causes of Melasma

There can be various factors responsible for causing melasma or increasing its risk. Let’s discuss them further.

  • Antiseizure medications – Medications that help prevent seizures might also cause melasma symptoms in patients.
  • Oral contraceptives – Individuals who take oral contraceptive pills containing estrogen and progesterone can develop melasma.
  • Estrogen/Diethylstilbestrol – Diethylstilbestrol is a synthetic form of estrogen hormone. Doctors recommend them for treating prostate cancer. Increased estrogen levels can increase your risk of melasma.
  • Phototoxic drugs – Certain antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), retinoids, diuretics, hypoglycaemic, etc., can cause a phototoxic reaction. As a result, patients might experience melasma.
  • Hypothyroidism – Patients suffering from underactive thyroid or hypothyroidism are also at a high risk of developing melasma.
  • Pregnancy – Increased estrogen levels, progesterone,  and the melanocyte-stimulating hormone during the third trimester of pregnancy can cause melasma symptoms.
  • Cosmetic products – Certain cosmetic products can cause phototoxic reactions and develop melasma in individuals.
  • LED screens – LED lights from laptops, tablets, mobile phones, television, etc., can cause melasma symptoms.
  • Sun exposure – Frequent and prolonged exposure to UV rays can also trigger melasma.
  • Genetics – Many melasma patients admitted that someone else in their family also suffers from the same condition.

Symptoms of Melasma

The main symptom of melasma is hyperpigmentation, where the patients will develop uneven skin tone or brown or bluish patches on the skin. It doesn’t cause any other physical symptoms apart from these patches. However, patients might feel concerned about their appearance. Mostly, these patches appear on facial skin, such as the bridge of the nose, cheeks, forehead, etc. Some people might develop melasma on their arms and neck.

You must know that melasma is not a form of cancer. However, some other skin conditions might cause symptoms similar to them. In such cases, it is better to consult your skin doctor at an aesthetic clinic JB for proper diagnosis and the needed treatment of melasma.

This skin condition can cause various shades of brown or bluish patches on the skin. Some might resemble freckles. Usually, they appear in six locations on the skin.

  • Brachial melasma – When you develop patches on the shoulders and upper arms
  • Malar – When symptoms occurs on the cheeks and nose
  • Centrofacial – When you notice patches on cheeks, nose, forehead, and upper lips.
  • Lateral cheek pattern – Symptoms appearing on both cheeks
  • Mandibular – When patches occurs on the jawline
  • Neck – In older people aged 50 years or more, melasma can occur on different sides of your neck

Diagnosis of Melasma

Your dermatologist Johor Bahru will medically examine your skin condition to diagnose melasma. They might use Wood’s Lamp (black light) to identify changes in your skin colour. Further, they might also recommend thyroid testing to diagnose whether your thyroid level is responsible for causing this condition.

Certain medical conditions might also cause melasma-like symptoms. For proper diagnosis, your skin doctor might also perform a biopsy. During this test, they will remove a small piece of your skin and examine it. It is a safe procedure that your doctor can perform at their office. The following are the skin conditions that are often mistaken for melasma.

  • Lentigo or liver spots
  • Pigmentation caused as a result of certain medications
  • Nevus of Ota, where hyperpigmentation occurs around the eyes
  • Nevus of Hori, where hyperpigmentation occurs around the malar region and both sides of your forehead
  • Post-inflammatory pigmentation
  • Exogenous Ochronosis is caused due to the long-term application of skincare products containing hydroquinone or topical contact with resorcinol or phenol.

Your skin doctor might further use the Melasma Area and Severity Index (MASI) test to measure the severity of your symptoms.

Melasma treatment

Prevention and Treatment of Melasma

Suppose hormonal changes during pregnancy or consumption of oral contraceptives are responsible for causing the melasma. They will go away after the baby’s delivery or when you stop taking the pills.

On the other hand, a dermatologist at an aesthetic clinic, JB, might recommend using a sunscreen with SPF 30 or higher to prevent the development of symptoms. You may consult them to learn about the suitable sunscreen you should use based on your skin type. Further, it is better to cover your skin when stepping into the sun. Wearing a hat outdoors can also offer additional protection against the sun.

Moreover, not every treatment method can provide the same results for all. Based on the severity of your skin condition, your skin doctor will determine a suitable treatment plan accordingly.

Usually, your dermatologists might use the following methods to treat melasma. Let’s learn more about them.

Topical Medications

As the first line of treatment, skin doctors usually prescribe topical medications. Before applying any topical medications to the affected skin, it is better to do a patch test to ensure they are safe for your skin. Usually, they recommend the following topical medications for treatment purposes.


Skin doctors often use hydroquinone as the primary treatment for melasma. This medication is available in gel, lotion, or cream. You can apply this medication directly to the affected skin areas. Various studies reveal that hydroquinone can help reduce pigmentation effectively and can even out dark patches of skin. Sometimes, doctors may often combine this treatment with topical retinoids, such as tretinoin, to treat severe cases of melasma.

Corticosteroids and tretinoin

Besides hydroquinone, skin doctors can also suggest corticosteroids and tretinoin treat persistent melasma symptoms. You can find these medications in topical creams, gels, and lotions. Hydrocortisone is a topical corticosteroid that your doctor might recommend using. It helps fade the pigmentation resulting from your skin condition. Further, it might help reduce the possibility of the development of dermatitis that can occur due to the use of other skin products.

If required, your doctor might also advise using combination creams that include hydroquinone, corticosteroids, and tretinoin.

Other topical medications

If needed, your skin doctor might also prescribe kojic or azelaic acid to treat melasma. Based on your skin condition, they might suggest these topical medications either along with other medicated topical products.

Azelaic acid – These are available in cream, gel, and lotions. Your doctor might recommend using this topically twice a day. Even pregnant women can use this topical medication as well.

Cysteamine – Sometimes, skin doctors might recommend topical application of cysteamine to treat your condition.

Methimazole – It is an antithyroid medication that might help treat your symptoms.

Medical Procedures

If these topical medications don’t offer you the desired result, your skin doctor Johor Bahru might recommend the following medical procedures. Let’s discuss them further.


Along with topical medications, microdermabrasion can also help treat melasma. Skin doctors often use combination therapies to address underlying concerns.

If melasma affects the epidermis or outer layer of your skin, this procedure can help achieve great results. It is a minimally invasive procedure, and hence, doctors will not perform anaesthesia. Your doctor will remove the outermost skin layer during this procedure without affecting the underlying skin. They use a tool with an abrasive attachment to exfoliate the outer skin layer and boost new cell production. As a result, you will develop a new epidermis with visibly less discolouration and hyperpigmentation.

Chemical Peels

Usually, chemical peels vary in their strength and application based on the patients’ skin conditions. Further, they prepare the skin to absorb topical medications deeply to improve their efficiency.

The chemicals used in this treatment procedure are –

  • Glycolic acid – Derived from sugarcane, it is an organic compound that can help treat melasma effectively. It boosts cell turnover resulting in a new epidermis without the irregular melanocytes.
  • Salicylic acid – It is a beta-hydroxy acid that helps in epidermis breakdown. Moreover, due to its anti-inflammatory properties, it is safe for your skin.
  • Tretinoin – Like topical products, tretinoin used in chemical peels helps in cell turnover.

Laser treatment

A skin specialist in JB might also use laser treatment for melasma. The following are the various lasers that your skin doctor might use for treatment purposes. Let’s learn about them further.

Fractional laser

This procedure will make microscopic holes in your skin to promote new and healthy skin cell growth. Usually, your doctor will apply a topical anaesthetic before the procedure. You may notice your skin appears red or discoloured immediately after the treatment. However, within a few days to a week, your skin will appear even-toned and brighter.

Q-switch laser/Pico Laser

This laser treatment delivers energy into your skin to break melanin pigments into smaller segments. Further, your body helps remove them. However, be mindful that this treatment method can bleach your hair, and you may experience a stinging sensation.

Studies revealed that women who experience melasma during pregnancy and are not planning to get pregnant again could opt for laser treatment. Moreover, if other medical procedures have not worked for patients, laser treatment might help them get the desired results.

After receiving the first treatment session, you can expect visible improvements. However, you need to attend five  to six treatment sessions, each a month apart, for better results. Further, as melasma can recur, patients might need follow-up treatments.

Laser treatment might cause itching, stinging or burning sensation for several days after the treatment. Moreover, your skin might appear red, slightly swollen

To avoid the possible side effects, your doctors at a skin clinic in Johor Bahru might provide you with aftercare instructions to get optimal results. On your part, you need to follow these precautions during the recovery phase for better results.


Melasma is a chronic skin condition that occurs due to various factors. One of the effective ways to prevent the worsening of your symptoms or recurrence of this condition is the application of sunscreen with SPF 30 or high. You should apply sunscreen regularly, even on cloudy days. Consult your skin doctors to identify the sunscreen best suited for your skin. Moreover, they might also suggest using skin-lightening products after receiving laser treatment.

Identifying the type of melasma, the depth of pigmentation, the severity of your symptoms, etc., can help determine the suitable treatment for the same. Various treatments can cause certain side effects or additional skin concerns. Hence, you must consult your skin doctor to learn about possible side effects.

Dermed Clinic is a skin clinic in Johor Bahru that helps treat a wide range of skin concerns. These might not be severe health concerns; however, they might make you feel bothered about your appearance. Dr Muniandi can help diagnose your skin concern to offer the needed treatment. If you suffer from melasma, consult him for further medical assistance.

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