Sign in

Melasma: Identification and Treatments

Robert Manzo February 2014 issue of Skin Inc. magazine

Get the Skinny! This is just part of the article. Want the complete story, plus a host of other cutting-edge articles to make your job easier? Sign up!

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.

Want the rest of the story? Simply sign up. It’s easy. Plus, it only takes 1 minute and it’s free!

Related Content



7 Tips for Treating Melasma

  1. Determine the root cause by examining the client’s skin health history, observing pigmented lesions, determining when and what associative factors accompanied the onset of melasma,1 and performing proper imaging and biometric analysis.

  2. If PIH is present, do not apply light, heat or peel modalities of treatment as the first course. Suppress any active inflammation first; then, it is safe to lighten skin with topicals, followed by light, heat or peel treatments.

  3. Epidermal melasma, which is active, should not be treated with laser or IPL.

  4. Dermal melasma is very difficult to treat. Customized formulations, which provide the depth of the bioavailability of active lightening agents, are critical to success.

  5. Combination treatments are often extremely successful in treating melasma when performed in a specific sequence or concurrently, depending on specific conditions.

  6. When treating any hyperpigmentation disorder with lasers, IPL or chemical peels, pre-treat for a minimum of two weeks with a potent skin-lightener to immobilize the melanocytes—often hydroquinone alone is not enough—followed by a post-treatment regimen of one month.

  7. If you suspect PIH is occurring after a procedure or when a client presents for treatment, apply skin-lighteners with anti-inflammatories immediately. In general, clinical studies have indicated that once PIH persists on skin for 10 days to two weeks, it is very difficult to suppress.

Case Study 1: UV Imaging

Unlike dermal melasma, epidermal melasma is visible in color UV imaging.

Case Study 2: Image 1 and 2

In order to address sun damge, this client was over-treated with IPL, leading to PIH.


Case Study 3: Epidermal Melasma

Color UV reflected light imaging confirms epidermal melasma with little dermal melasma present.



Next image >



Welcome to the new!

Delivering the best information on the spa, skin care and wellness industry is our passion, and we’ve worked hard to design a powerful new website that incorporates cutting-edge technology to bring you:

  • Mobile-friendly Design
  • Integrated Sample Request
  • Refreshed Look and Feel
  • Dynamic Content
  • Free Registration

Mobile-friendly Design

Providing a unified experience from mobile to desktop, responsive design allows you to access Skin Inc. content from any device, whether you’re in the treatment room, at home or on the go!

Integrated Sample Request

Visit Featured Product pages to quickly and easily identify new suppliers and request product samples and information.

Dynamic Content

Articles are now linked with relevant products so you can find the products and treatments you need to provide the best results for your clients.

Free Registration

Create your user account to gain unlimited access to Skin Inc.’s unparalleled content.

Enjoy the New!

Thank you for joining the Skin Inc. community of passionate skin care professionals. We look forward to providing you the best information to enhance your career!