Now that it’s finally winter here in Florida and we are enjoying the cool winter weather it’s a great time to start thinking about treating those dark spots that the summer sun made so prominent. A visit to the dermatologist might be in order especially, if you notice dark spots or patches lingering on your forehead, chin, nose, upper lip, or cheeks, as they may be a sign that you actually have melasma.

Melasma is a pigment condition that can affect women (and some men) of all ages and which can last for years. It is not generally a concern health-wise, but it certainly can be distressing and life altering.

Melasma has been tied to pregnancy because it often shows up on pregnant women whose hormones are in flux, but other changes in hormones can cause melasma as well, which is why it is also common in those who begin or stop taking birth control or even hormone replacement therapies. Most commonly though it is seen in persons with no hormone exposure as a result of genetics and sun exposure. Because it is exacerbated by UV exposure, protecting your skin from harmful sun exposure is extremely important. The problem as many patients discover is that even if you stop hormonal treatments and protect yourself from the sun it does not mean melasma will vanish. Once it has begun it is very difficult to resolve.

Treatment Options

If you have melasma and it’s not improving with sun protection and over-the-counter treatments what are your treatment options? There’s not a one-size-fits-all approach to melasma treatment. Everyone person is different and personalized treatment is the key to achieving success and for this reason Dr. Sullivan recommends a combination of treatments. Why? Because melasma is a stubborn foe and certain treatments can cause irritation which at times can make matters worse.

A good starting place for the treatment of melasma is a compounded topical cream. These can include prescription-grade ingredients like tretinoin, hydroquinone, and anti-inflammatories. Hydroquinone is highly effective especially at higher doses, but it should only be used for a limited period of time and then you need to take a break for several months. Other promising topical options include niacinamide, alpha-hydroxy acids, and tranexamic acid.

Alternatively, tranexamic acid can also be taken as an oral medication. This new medication has recently show dramatic results especially in patients who have failed other treatments.

In-Office Treatments for Melasma

If topical treatments for melasma don’t work for you there are a variety of in-office treatment options to reduce skin discoloration. Each has its own risks and benefits and must be integrated with your current topical regiment so it’s best to see Dr. Sullivan to find out what will work the best for your skin type. These in-office treatments include:

• microneedling
• laser therapy
• topical peels

To learn more about your skin’s discoloration or if you suspect you have melasma, schedule an appointment with SullivanDermatology or by calling 954.533.1520.