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Melasma: Identification and Treatments

By: Robert Manzo
Posted: January 31, 2014, from the February 2014 issue of Skin Inc. magazine.

Melasma is a subset of a general condition in the skin called hyperpigmentation. It is important to understand how skin develops hyperpigmentation, as well as to become familiar with the general types in order to manage the condition with the proper modalities. This article deals with the various root causes of nondisease-oriented hyperpigmentation and treatment methods to utilize, as well as treatments to avoid, depending on the specific type.

Skin color is developed by melanocytes: color-producing cells in the skin that determine different types and colors of melanin. Melanosomes are color organelles, or subunits, that are transferred from the melanocytes to the keratinocytes, which live in epidermal skin cells. The color of a person’s skin is largely dependent on a variety of factors including, but not exclusive to:

  • The amount of melanin produced;
  • The ratios of the type of melanin;
  • The size of the melanosome; and
  • The distribution of melanin throughout skin.

Pigmentation disorders

Aesthetically pleasing skin—no matter what color—exhibits an even distribution of melanin throughout. Skin that has even tonality is pleasing to the eye and contributes to the common idea of what is perceived to be beautiful. There are several pigmentation disorders that arise in skin, leading to uneven tone.

Oxidative damage. Oxidative damage commonly results due to UV light exposure from the sun, and takes the form of discrete spots on skin, which are often concentrated on the forehead, and across the cheeks and nose. Ingredients, such as endonucleases, can aid in improving this kind of hyperpigmentation.

Post-inflammatory hyperpigmentation (PIH). PIH often results from active cystic acne and after laser or intense pulsed light (IPL) treatments, as well as other mechanically induced skin trauma. The inflammation produced from these and other sources leads to higher localized melanin production in the skin, which results in hyperpigmentation.

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