Melasma is a skin condition in which darkened areas of skin appear on the face, and sometimes, the forearms. The dark patches typically develop on the upper lip, on the nose, and in symmetric areas around the cheeks and eyebrows and can be grayish, brown, or tan. The unique symmetry of melasma distinguishes it from other conditions that cause darkening of the skin. Both men and women can develop melasma, though it is much more common in females, especially in pregnancy and menopause. It can also be caused by sun damage, and existing patches of melasma can be aggravated or darkened by sun exposure. Though sun exposure does play a part in melasma, it seems to be more common in individuals with darker complexions than those with pale skin. If you have melasma and are frustrated with your appearance, consider scheduling a consultation at Pacific Skin and Cosmetic Dermatology San Francisco. Dermatologist Tracy Evans and her professional medical team can evaluate your condition and prescribe a number of treatments that can help reduce the visibility of this cosmetic condition.
"I've always been treated with kindness and respect by everyone. Dr. Evans is a wonderful doctor. Patient, trustworthy, and kind."- B.B. / Google / Jul 21, 2019
"I've been a patient for several years, and undergone several biopsies and skin cancer excisions. The level of care is excellent. The attention to detail is unsurpassed. Their work is always first rate, in a clean, friendly, caring environment. It is clear that Dr. Evans and her excellent staff truly cares about achieving the best possible result with every procedure."- S.E. / Google / Jul 17, 2019
"Tracy Evans, MD makes time to answer all of your questions, takes your concerns very seriously, no matter how small they may seem to you. Her staff is excellent and very respectful."- R.A. / Google / Jun 21, 2019
"Dr. Tracy Evans and her medical as well as office staff are a pleasure to interact with. They are always respectful, kind, friendly, skilled and competent. They are each and all excellent in their provision of care. I have seen them over 2-3 yrs for evaluation and treatment of skin with considerable sun damage. I frequently require minor surgery (MOHS - 3-5 times a year); Dr. Evans and her assistants are invariably gentle, thorough and kind. The doctor always calls the evening after surgery to check on me. I am grateful for their care.One point: if you have a copay, don't go unless you can cover it, you will not be seen without it. Also don't miss appts without cancelling in advance, you will be charged a penalty except in emergencies.😃😃😃😃😃"- M.M. / Google / Jun 20, 2019
"Dr Evan's has been treating my various dermatological issues for several years. Every visit is met with professionalism and complete confidence with what I present. When I needed further diagnosis she was quick to refer me to a specialist. Dr Evans has made herself available on a few occasions after hours to discuss my emergent needs."- Anonymous / Healthgrades / May 28, 2019
The exact cause of melasma is unknown. Experts believe that the dark patches in melasma could be triggered by several factors, including hormone fluctuations, a family history of melasma, anti-seizure medications, and other medications that make the skin more sensitive to ultraviolet (UV) light. Darker skin seems to be more prone to developing melasma. Overexposure to sunlight is considered the leading cause of melasma, especially in individuals with a genetic predisposition to this condition. Clinical studies have shown that individuals typically develop melasma in the summer months when the sun is most intense. In the winter, the hyperpigmentation tends to be less visible or lighter. Pregnancy hormones also seem to be a trigger, as around 50% of women develop melasma while pregnant.
Melasma is characterized by symmetrical discoloration or hyperpigmentation primarily on the face. However, some patients do have melasma on the forearms and neck area. Three types of common facial patterns have been identified in those with melasma:
- Centrofacial – (center of the face) hyperpigmentation on the forehead, upper lip, nose, and chin
- Malar – (cheekbones) dark patterns on the upper cheeks
- Mandibular – (jawbone) discoloration along the jaw
There are several options for treating melasma, but the method Dr. Evans will choose will depend on factors, like your skin type and how long you've had melasma. Dr. Evans has developed her own unique treatment plan for melasma, which she may determine is a great option for you. There are also a variety of medical-grade topical creams, gels, or lotions that can be used to exfoliate and lighten the skin. Dermatology resurfacing treatments, such as microdermabrasion, chemical peels, or fractional laser procedures, which remove old skin and promote regrowth, have also been successful. Another option is intense pulsed light therapy or IPL. Unlike lasers, which use intense, focused light, IPL is intense broadband light so the recovery time is briefer. Improvements usually last longest when the patient implements good sun protection and skin care.
Get a Professional Diagnosis
While melasma is a very common skin condition that many women deal with, it can be tricky to treat. There are many over-the-counter remedies available, but using the wrong one can ultimately make your melasma darker. If you have experienced this problem or are simply fed up with OTC creams not working as advertised, it is time to see a professional dermatologist. Schedule your consultation with Dr. Tracy Evans or one of her experienced physician's assistants at Pacific Skin and Cosmetic Dermatology San Francisco to start your journey back to an even skin tone.