Skin spots are more frequent in women, especially in women of childbearing age, although, according to dermatology specialists, they can also appear in men. They are more frequent in patients of Asian and Hispanic origin.
Causes of melasma:
It is known that there are multiple factors that can favor its appearance such as pregnancy, hormonal contraceptives, estrogen treatments, some anti-epileptic medication, genetic factors, ovarian pathology, some cosmetics and exposure to the sun or other ultraviolet radiation. Skin spots usually appear on the cheeks, nose, forehead, chin and upper lip. Their distribution is usually bilateral and symmetrical.
Treatment of melasma:
Treatment of melasma is individualized as each patient and each skin is different. A general guideline is to eliminate if possible those factors that could be favoring the appearance of spots, such as certain drugs or cosmetics, and exposure to solar radiation.
All treatments must be accompanied by a high photoprotection that must be applied at least twice a day throughout the year in the correct way or the result will not be the same.
- The most commonly used topical treatments with depigmenting effect are hydroquinone, retinoic acid, azelaic acid, kojic acid, arbutin, α-lipoic acid, glycolic and salicylic acid, vitamin C and recently tranexamic acid.
- Mesotherapy, can be performed with the same active ingredients used in topical treatment but with a faster action.
- Chemical peels: they can be performed in the office and can be superficial or deep (the latter are not usually recommended in this pathology due to possible complications and side effects). The most commonly used are glycolic acid, salicylic acid, Jessner, trichloroacetic acid, retinol and azelaic acid.
- Dermabrasion.
- Lasers. The fractionated ones have advantages over the previous ones.
Generally these last two options are reserved for very specific cases and resistant to other treatments due to the high rate of recurrence and possible complications, in addition to their higher cost.
The treatment is usually difficult, long, and the best results are obtained by combining several types. It is necessary to be very constant to achieve, if not a complete cure, at least an improvement.