Written by Dr. Kenneth Helmandollar
Working primarily with skin of color patients throughout my dermatology residency in Spanish Harlem and Coney Island provided me with a unique opportunity to treat conditions that are more often seen in these populations. One such common condition is called melasma. This disorder involves light to dark brown hyperpigmented patches primarily in sun exposed areas of the face. It is more frequent in women with darker skin types, including individuals of Hispanic and Asian descent, most often occurring after puberty during the reproductive years. The exact cause of melasma is not currently well defined, however known contributing factors include thyroid abnormalities, sun exposure, pregnancy, and some medications. Although there are varying degrees of severity, most patients I have encountered are negatively impacted psychologically from this condition.
Helping patients to understand the role of ultraviolet light in this condition and discussing ways to minimize this exposure is key to achieving the desired results and maintain them. The cornerstone of treatment is frequent and liberal use of sunscreens with SPF 30 or higher that cover broad-spectrum UVA/UVB. My favorite sunscreens to use for this condition are those that are “tinted.” This means that they contain additional ingredients, such as zinc oxide, that blocks visible light which has recently shown increasing correlation to the development of melasma. This should be used year around regardless of if an individual goes outside or not, as even sun exposure through windows can exacerbate melasma. Re-application of sunscreen every two to three hours is ideal as well as the use of protective clothing, and wide-brimmed hats.
In addition to sun avoidance measures, there are several over-the-counter and prescription topical treatments that can improve melasma. For mild cases, I like using an azelaic acid cream, which can be purchased at common beauty supply stores such as Sephora or Ulta Beauty. Prescription formulations including hydroquinone alone or in combination with corticosteroids, tretinoin, kojic acid, or glycolic acid are the most used and efficacious. Procedural-based treatments including superficial chemical peels, laser, and intense pulsed light can be beneficial as second-line therapies. An oral treatment called tranexamic acid has shown promising results but needs to be reserved for the appropriate patients given its potential side effect profile.
It is important to realize that melasma is not a curable condition but one that must be managed over time, as relapses do occur. Working together with a board-certified Dermatologist at Advanced Specialty Care to come up with an individualized treatment plan can help patients achieve their desired outcomes. Call us today or instantly book your appointment online at one of our offices in Danbury, New Milford, Ridgefield, Norwalk or Stamford, CT.
—Kenneth Helmandollar, MD
Dr. Kenneth Helmandollar specializes in a range of skin conditions, including eczema, psoriasis, rosacea, blistering diseases, acne, as well as the detection & treatment of skin cancers. He performs surgical excisions of benign & malignant lesions, cosmetic procedures including injectables, and patch testing for Allergic Contact Dermatitis. He is a member of the American Academy of Dermatology and the American Society of Dermatologic Surgery. Dr. Helmandollar is now accepting patients in Danbury, Ridgefield & Norwalk.
ADVANCED SPECIALTY CARE
To schedule your appointment with one of our Dermatology specialists at any of our convenient office locations in Danbury, New Milford, Norwalk, Ridgefield, or Stamford, give us a call or request online today.
Related Blogposts
Advanced Specialty Care’s Dermatology practice is welcoming and patient-centered, specializing in all of your family’s skincare needs from head-to-toe. Our board-certified Dermatologists excel in general medical, surgical and cosmetic dermatology for patients of all ages, with expertise which allows them to not only diagnose and treat complex skin conditions, but also improve the appearance and condition of the skin.