Melasma: What it is and How to Treat it


With causes not yet fully defined, these spots have several types and possible treatments

Melasma is a dark spot that appears on the skin without apparent cause, which can improve or worsen with treatment but has no cure. They usually appear, mainly in women over 30 years. However, that does not mean that men cannot be affected.

They are found mainly in the forehead, cheekbones and chin, and less frequently in the arms, neck and lap.

Types of melasma

The first symptoms are already the spots themselves. They do not sting or burn. They have irregular and well defined shapes, being generally symmetrical on both sides of the face. Their types refer to the layer in which the spots settle and are equally difficult to treat:

Epidermal: characterized by the accumulation of melanin in the upper layer of the skin, the epidermis, being the type that appears most.

Dermal: Under the epidermis is the dermis, where the vessels, the nervous network and the like are housed.

Mixed: as the name implies, the spots are on the two layers of the skin.


It is not yet known what causes the accumulation of melanin in these regions of the skin. What is a consensus among experts is that exposure to sunlight stimulates the action of melanocytes, which are the cells that produce melanin, which gives color to the skin, and melanosis, which is the accumulation of melanin in the tissues.

In addition to sun exposure without the use of sunscreen on a daily basis, according to the Brazilian Society of Dermatology (SDB), some factors are considered risks for the appearance of melasmas:

  • Use of female contraceptives;
  • Pregnancy, mainly by oscillation of hormones;
  • Genetic factors;
  • Thyroid dysfunction;
  • Use of cosmetics or medications for hypertension and epilepsy.
  • When and what doctor to consult

To follow up and treat melasma, you should consult a trusted dermatologist, preferably an expert in the field.

Do this as soon as you notice the changes in the skin, starting the treatment as soon as possible. The use of sunscreen is independent of the consultation. Start using one that suits your skin as soon as possible.

How to deal with

Unfortunately, there is no cure for melasma, but there are some treatments designed to soften the spots. The SDB explains that the treatment for melasma “always provides a set of measures to clarify, stabilize and prevent the pigment from returning.”

It is important to remember that homemade treatments with lemon, baking soda or any ingredient that is not recommended by a specialist should be avoided as much as possible.

1. Whitening creams

The most suitable are creams based on hydroquinone, glycolic acid, azelaic acid and retinoic acid. This method does not work for all patients and may take about two months to begin showing results.

Although it provides results that take less time, experts say it takes time to stabilize the stains and avoid minimal exposure to the sun so that it does not cause a setback of all improvements.

2. Peeling

It can clear the skin gradually, and it is essential that a dermatologist indicates the type of procedure most appropriate for the type of spot. The peeling can act even faster than creams. Some are more superficial and others deeper.

3. Sun protection

A sunscreen with UVA and UVB protection is essential so that new spots do not appear, even if you are in a closed environment.

Choose one that is suitable for the oiliness of your skin with a high sun protection factor and use it daily, replenishing it periodically, according to what the dermatologist recommends.

4. Laser and intense pulsed light

There are also laser treatments that reach the dermis and can show significant improvements. According to the SDB, this treatment should be done carefully so as not to generate more pigmentation. Therefore, it is essential that you do it with a professional specialized in the field.

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