Melasma is a frequent skin condition seen most commonly in women, and presenting as blotchy brown pigmentation on the central face. Melasma is worsened by sun exposure as well as taking estrogen replacement and oral contraceptive pills. Melasma can be frustrating to treat and does not respond predictably to treatments.
Most people develop melasma on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It also can appear on other parts of the body that get lots of sun, such as the forearms and neck. People with darker skin types and those who have a blood relative who had melasma are much more likely to get melasma. The cause has not been fully elucidated, but factors such as hormones, sun exposure, irritation and heat can exacerbate melasma.
Dr. Kittridge has treated numerous melasma patients successfully with topicals alone. She uses customized compounded medications with impressive results in most patients, saving them thousands of dollars on laser treatments that often provide little improvement. Diligent use of these topical prescription medications combined with an excellent daily sunscreen provides effective treatment for many melasma patients. Additional treatments include gentle physician-grade peels and, on occasion, systemic treatment with pills by mouth.