Melasma
What is melasma?
Melasma is a chronic skin hyperpigmentation that appears as brown or grayish patches on the face, most commonly on the cheeks, forehead, and upper lip. Its treatment requires specialized dermatological care, consistent sun protection, and the use of depigmenting products.
Causes of melasma
Melasma is a multifactorial condition, meaning that several different factors can contribute to its development:
Hormonal Factors
Melasma, one of the main causes of skin pigmentation, most often affects women of reproductive age due to hormonal influences. These dark spots typically appear during periods such as ovulation, menstruation, pregnancy, or even during assisted fertility treatments.
Genetic or hereditary factos
It is common for people with facial pigmentation to have other family members affected by the same condition, most often women (such as mothers, grandmothers, or sisters). It is estimated that there is a genetic predisposition in up to 50% of cases.
Environmental Factors
Melasma can be caused or worsened by environmental factors such as unprotected sun exposure, tanning beds, and blue light from electronic screens. Chronic stress and emotional imbalance can also play a role in its development, as they are linked to elevated cortisol levels, inflammation, and consequently, hyperpigmentation. Poor nutrition further contributes to the appearance of dark spots. Although less common in men, melasma can also occur due to excessive sun exposure or an unbalanced diet.
Symptoms
The main symptom of melasma is the appearance of dark skin pigmentation, often perceived as black or brown spots. These spots can be symmetrical, appearing on both sides of the face, which is why they are commonly referred to as “butterfly-shaped” or “mask-like” patches. The areas most frequently affected by melasma include the cheeks, forehead, and the upper lip area (commonly known as the mustache or philtrum zone).
Diagnosis
Melasma is diagnosed clinically, meaning that no laboratory tests or additional studies are required to confirm it. Diagnosis is typically made through a visual examination, during which the physician identifies the condition based on the shape, distribution, and dark coloration of the skin spots.
Melasma treatments
Since melasma is a systemic condition influenced by multiple factors such as hormonal balance, genetics, and inflammation caused by environmental conditions, its treatment must be comprehensive. It’s also important to note that melasma can reappear, as it is a chronic condition. However, patients treated by Dr. Juan Carlos Lloreda, a specialist in aesthetic and anti-aging medicine and an expert in managing melasma and other skin pigmentation disorders, have achieved remarkable results through a structured treatment protocol. His ongoing monitoring of each patient’s condition, combined with consistency and personalized care, has made Dr. Lloreda one of the few physicians in Colombia successfully treating this condition.
Treatment for skin depigmentation may include:
Laser Q – Switched
The Colormax laser treatment for pigmentation removal works by fragmenting the pigment within the intradermal layer without damaging the skin’s surface, or epidermis. It uses high-intensity laser pulses of extremely short duration to precisely target affected areas. This technology allows the laser energy to reach deeper layers of the skin, treating the pigmented molecules effectively while leaving the surrounding tissue unharmed.
Biostimulators
These are substances that enhance the extracellular matrix to stimulate collagen quality, firmness, radiance, elasticity, and overall skin health. They are used as part of melasma treatment, as the goal is to address sun damage and aging, factors that contribute to the appearance of dark spots. The purpose of these products is to repair and improve tissue quality to achieve more satisfactory results.
IV Therapy
IV infusions are part of a comprehensive treatment approach and complement the main procedures, as they help regulate the hormonal factors that trigger pigmentation and the inflammation associated with melasma. In this way, they optimize the skin’s natural processes and address the root cause of the problem, not just its visible effects.
Chemical Peel
Chemical peels stimulate skin regeneration and tissue remodeling through the application of exfoliating agents and are commonly used in the treatment of melasma. A chemical agent is applied to remove the superficial layers of the skin, improving texture and helping to control the appearance of dark spots by inhibiting melanogenesis, the process through which melanin is formed.
Tranexamic acid
This is a synthetic amino acid that can be useful in certain cases, as it helps reduce skin pigmentation by decreasing tyrosinase activity and melanogenesis, leading to a reduction in epidermal pigmentation and the number of blood vessels. It can be administered through mesotherapy, microneedling, topical creams, serums, or orally.
Skincare
Maintaining an appropriate daily skincare and cleansing routine supports melasma treatment. For instance, using vitamin C is recommended to stimulate collagen production and take advantage of its antioxidant and anti-inflammatory properties. Gentle soaps or cleansers should be used for daily cleansing. It is essential to apply sunscreen every day and avoid direct sun exposure, as well as to use hats, caps, or umbrellas to help block the sun’s effects on the skin.
Expectations
Patients at Dr. Juan Carlos Lloreda’s Aesthetic and Anti-Aging Medicine Center report a low recurrence rate and up to 90% improvement, results that exceed the average. Dr. Lloreda is currently conducting scientific research aimed at helping the medical community update treatment protocols for melasma and achieve better outcomes for patients.
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Frequently Askes Questions
What should I do if I have darks spots on my face?
Do not use just any product to treat melasma or dark spots. Natural remedies for skin depigmentation are generally ineffective and, worse, can aggravate melasma. Achieving good results in patients who have undergone previous interventions or used unsuitable products can also be more difficult.
Avoid the use of oral or injectable contraceptives. According to Dr. Lloreda’s experience, in women with a genetic predisposition, these can be a contributing factor in the appearance of skin pigmentation.
Avoid excessive sun exposure without proper protection.
Maintain a healthy lifestyle, as poor nutrition and chronic stress promote inflammation and contribute to the development of melasma.
What worsens melasma?
Not using sunscreen, experiencing chronic stress or emotional instability, maintaining poor eating habits, or applying home remedies and unapproved products to remove dark spots can all worsen the condition if they are not part of a specialized, comprehensive treatment plan.
Does melasma have no cure?
It is a chronic condition that may reappear after treatment. However, Dr. Lloreda’s protocols have shown a low recurrence rate when patients follow the recommended care guidelines.
How long does melasma last?
It is not possible to determine exactly how long this condition may last, as it is chronic. However, with proper treatment, there can be a significant reduction in pigmentation and a lower chance of recurrence. A specialized diagnosis is essential, since the characteristics of skin spots can vary depending on triggering factors such as genetics or environmental influences, including stress or the use of products that may worsen the condition.
Because it is a hormone-related condition, women often notice an improvement in pigmentation during menopause, as hormonal activity decreases significantly.
Following the treatment recommendations and completing the at-home care routine contribute to achieving optimal results.
Recommendations
To ensure optimal results, it is very important to follow the recommendations provided by Dr. Juan Carlos Lloreda:
Reduce the consumption of ultra-processed foods and meals containing gluten, wheat, or barley, as they promote inflammation and increase the likelihood of developing skin pigmentation.
Avoid the consumption of milk, sugars, and carbohydrates.
Limit sun exposure without proper photoprotection, as radiation on pigmented skin can affect the appearance, recurrence, coloration, and depth of the lesions.
Apply the prescribed topical products as part of the treatment for the recommended duration.
Attend all scheduled treatment sessions and follow-up appointments.
How to prevent melasma
Melasma cannot be completely prevented, but its appearance and intensity can be controlled. Since it has hereditary factors, patients who recognize the condition in their family history should pay special attention to sun protection, using sunscreen and protective clothing. Sunlight is beneficial, but only 10 to 20 minutes of direct exposure per day are needed to obtain its positive effects.
Maintaining a balanced diet that avoids, as much as possible, inflammatory products such as ultra-processed foods helps in controlling the condition. Likewise, getting sufficient sleep and finding healthy ways to manage stress, anxiety, or depression are essential components of both the prevention and treatment of melasma.
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