WHAT IS MELASMA? - Melasma is a common skin condition that causes the appearance of brown patches on the face and chest due to excessive production of melanin in these areas. Melanin is the pigment that defines your skin colour. It is produced by the melanocytes (pigment factory) located in the skin. Chronic sun exposure is considered the leading cause of melasma. The sun can stimulate the melanocytes to increase irregular pigment production in these areas. Melasma typically worsens in the summer months when the sun is most intense and more time is spent outdoors.

Melasma may also be caused by:

1. Family history of melasma.

2. Hormonal fluctuations, i.e. pregnancy, oral contraceptive pills or hormonal replacements.

3. Drug sensitisers (i.e. intake of certain drugs that allow the skin to tan easily).

These factors allow the skin to produce more pigment when exposed to the sun. Melasma usually occurs on areas of the skin that are exposed to the sun, such as the face, chest, hands, forearms and legs.

TREATMENT FOR MELASMA

The first step is to do a chemical peel to the affected area (usually the face). A minimum of three treatments over a period of one to three months is required depending on severity and the individual's response to the chemical peel. This treatment frequency can be decreased or increased.

The second step is the nightly application of a specially compounded fade cream specific for each individual to target the brown patches. The fade cream suppresses the production of pigment and gradually lightens the brown patches, resulting in a more even

skin tone.

The third and most important step is the daily use of sunscreen, especially to the affected areas. Additionally, it is crucial that the individual minimise sun exposure in order to ensure successful outcome of the treatment.

Even after your melasma has cleared, regular maintenance therapy is required to prevent melasma from returning.

If you are in the sun for long periods, you should wear a hat to protect your face in addition to wearing sunscreen SPF70 and above.

Next week I will be discussing eczema, which worsens in the summer months. Remember

your sunscreen; it is an important part of your daily skin care regimen!

Dr Patricia Yap is a dermatologist at Apex Skin Care and Laser Center.