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Dr. Prakash Acharya, MD (Board Certified Dermatologist)
How does melasma occur?
To protect our skin from the sun, the cells in our skin known as melanocytes produce a pigment called melanin. And this melanin gives our skin color. If there’s over production of melanin, it presents as melasma.
Similarly, newer studies have also shown the role of vascular factors in melasma.
What are the causes of Melasma?
There are three main reasons for melasma.
1. Hereditary – When other family members have similar condition.
2. Hormones – So often seen during pregnancy. But it can also be seen at other times.
3. Sun – UV rays from the sun’s rays aggravate melasma.
In addition to this, the use of various skin products, chemicals, exposure to the fire or heater also increase melasma.
How is melasma treated in Nepal?
Melasma should always be treated with the advice of a dermatologist. It is often treated with ointments containing hydroquinone, tretinoin, azelaic acid, tranexemic acid, cysteamine (Cyspera), kojic acid, etc. These ointments can sometimes irritate the skin for which steroids are also used sometimes. Also serums like Vitamin C, Niacinamide, Retinol can be used. Tranexemic acid tablets are often used if the ointments do not work. But it should be used very carefully on the advice of a dermatologist.
Chemical peeling, microneedling, etc. are also used to treat melasma.
The most important treatment is sunscreen. It is important to use it regularly and avoid sun exposure.
How long does it take to see the effect of melasma treatment?
In most cases, it takes 1 to 2 months for the treatment to take effect. That is why treatment should not be discontinued for some time.
Does melasma treatment work only for the treatment duration?
Melasma is a kind of a chronic disease unlike any contagious disease or allergies. Therefore, the treatment alone is not usually sufficient to eradicate it. But if the treatment is done on the advice of the doctor and maintenance treatment is continued, it can be largely controlled.
Is it okay to use creams like Melacare, Skinlight, SkinShine or parlor-based creams?
Most of these ointments and creams contain steroids which usually fade melasma within a few days. But when we stop using them, the melasma recurs. If these products are continued for a longer time, the skin becomes thinner, red, itchy, and sensitive. Similarly, it is very difficult to treat the damaged skin later. So one should never use such ointments or creams without prescription.
Where is the best treatment for melasma available in Nepal?
Melasma should always be treated by consulting a licensed dermatologist. At Reva Skin and Hair Clinic, Kathmandu, proper treatment of Melasma is done by Prakash Acharya, MD.