Dark Spots, Hyperpigmentation, Melasma
Melasma is a disorder of skin pigmentation. The pigment (melanin) is synthesized by pigment cells (melanocytes). We see the deposit of the melanin (melanin granules) as hyperpigmentation. Pigment spots occur typically later in life and look like light-gray to dark-brown patches. They appear mostly on sun-exposed areas, such as faces and arms.
Currently, we don’t know the factors and rea- sons behind the emergence of melasma. We attribute it to sunlight and genetic predisposition.
The main risk factor for hyperpigmentation is exposure to natural or artificial UV radiation as well as hormonal factors, which are crucial in the appearance of the melasma. Hormonal disturbances or the intake of oral contraceptives and pregnancy are aggravating factors.
Some cosmetic substances, such as oxidized linoleic acid, salicylate, citral, and preservatives, can be triggering factors for melasma. Medications described as phototoxic or photosensitive, such as anticonvulsants, have been associated with melasma too.
Aesthetic medicine can significantly diminish all areas of hyperpigmentation, but it is impossible to completely remove some of them, especially melasma areas. The result of the battle with dark spots depends on how deeply it has localized. To understand the depth, we use Wood’s lamp. Using Wood’s lamp, we can see the superficial hyperpigmentation, called epidermal melasma, but not melasma that has spread deeper into the skin.
As with most individual treatments, it should be tailored to the patient’s needs.