“Is this melasma, blemishes, or what?”
Recently, an individual has noticed an increase in mirror checks, possibly due to dark spots appearing on the cheekbones after extended sun exposure during this summer’s prolonged heatwave.
After consulting with a dermatologist, the condition was diagnosed as melasma. The specialist warned that melasma is notoriously difficult to treat, and a complete eradication of the spots is unlikely.
This summer, the intense sunlight has caused many people to develop spots on their faces, not just freckles. Among pigmentary disorders caused by sunlight, melasma is one of the conditions dermatologists find most challenging to treat because it does not easily fade.
To effectively address melasma, it is crucial to confirm the diagnosis first.
Dr. Oh Sang Ho from Severance Hospital’s Dermatology Department explained, “Freckles and blemishes often appear as small spots with clear borders, while melasma typically shows up on the cheekbones and has a more diffuse and broader appearance.”
Dr. Oh notes that blemishes can range from a few millimeters to about 1-2 centimeters in diameter and usually present as well-defined, round spots. In contrast, melasma tends to be less defined and not as small.
Melasma is notably more common in women than men. Although the exact cause remains unclear, hormones are believed to play a significant role.
Dr. Oh adds, “Estrogen, a female hormone, is known to worsen melasma, which is why it is prevalent among women in their 30s and 40s. Many see improvement after menopause.”
UV rays also worsen melasma. Dr. Oh stated, “Many patients see their melasma worsen in the summer. It almost exclusively affects the face, though the exact reason remains unknown.”
Treating melasma requires repeated procedures. While conditions like freckles and age spots can be easily treated with good results, melasma often requires multiple treatments like laser toning. It can darken or not show immediate results.
Dr. Oh elaborates, “Melasma is one of the most challenging conditions for dermatologists. The goal is to lighten the pigmentation through repeated treatments rather than complete removal.” He emphasizes the importance of using milder treatments over several sessions.
Apart from laser treatment, various medication treatments are available. “Whitening agents are used, or one might go to a skincare clinic for Vitamin C ion therapy,” said Dr. Oh. “Recently, tranexamic acid, a medication that induces blood coagulation to prevent postoperative bleeding, has been found effective for melasma and is often used in combination.”
He concludes, “While treating melasma can be difficult, significant fading is achievable with proper treatment. Additionally, since melasma often recurs, diligent sun protection remains crucial even after treatment.”