Melasma, also known as chloasma, is a chronic skin pigmentation affecting women (and less frequently men) with rather dark skin tones (phototypes III to VI).
It is called a pregnancy mask when it appears during pregnancy. It draws a kind of mask on the face, hence the name, as it appears on the forehead, chin, bridge of the nose and cheeks.
The pigmentation can be more or less dark depending on two factors : the amount of pigment and the depth of the pigment.
In fact, there are three types of melasma :
• Epidermal melasma : the pigment is superficial, located at the epidermal level. The spots are brown in color.
• Dermal melasma : the pigment is deep, located in the dermis. The spots are more bluish.
• Mixed dermo-epidermal melasma : the pigment is found in both the dermis and the epidermis. The spots appear brown and gray.
It occurs following sun exposure (not necessarily repeated) and exposure to estrogens (pregnancy, contraception, certain conditions…).
Melasma is a common skin condition that affects millions of people worldwide. It is a pigmentation of the skin that occurs after repeated exposure to the sun or to estrogens. When it appears during pregnancy, it is also called the pregnancy mask. We do not know why some women develop it and others do not.
Unfortunately, this pigmentation does not disappear on its own, and any exposure to sunlight (or to estrogens) will worsen it. It is possible to get rid of the pregnancy mask using medical techniques. Without requiring surgery, melasma treatments in Geneva are performed in-office.
Melasma is a deposit of melanin, the pigment found in our skin that determines each individual’s skin color, produced by cells called melanocytes.
Darker skin phototypes are the most affected.
It is a chronic hyperpigmentation with fluctuating intensity. The spot may appear lighter or darker at different times.
Three factors are responsible for its development :
• Genetic predisposition : there are familial forms of melasma. Some individuals are more likely to develop melasma due to their genetic background. It is more common in people with darker skin, particularly those of Mediterranean, Asian, or Latin American origin.
• Sun exposure : ultraviolet (UV) rays stimulate melanin production in the skin. Prolonged and unprotected sun exposure can exacerbate melasma, and even after treatment, sunlight can trigger the reappearance of brown spots.
• Hormones : melasma is frequently linked to hormonal changes. It is especially common during pregnancy, hence the nickname “pregnancy mask”. Oral contraceptives and hormone treatments can also trigger this condition.
• Cosmetic products and skin irritation : using certain harsh or irritating cosmetic products can worsen melasma. Sometimes, products containing ingredients such as alcohol or fragrance can sensitize the skin and make melasma more visible.
• Stress and environmental factors : chronic stress may also play a role in the development of melasma. Additionally, environmental pollution can contribute to skin oxidation, thereby increasing the risk of pigmentation.
It is possible to have melasma without being pregnant.
The responsible factors are estrogens and sun exposure. Any sun exposure can trigger melasma.
A woman may have higher levels of estrogen without necessarily being pregnant, as in the case of certain conditions or the use of contraceptives.
Even a pregnancy that was interrupted can cause melasma.
It is difficult to prevent a pregnancy mask : one would need to avoid any sun exposure and avoid hormonal fluctuations.
Avoiding the sun is practically impossible — even short exposure can trigger melasma.
As for hormones, it is possible to avoid contraceptives, but changes in estrogen levels are not only caused by pregnancy.
Treating melasma is a frequent request.
Anti-dark spot creams (apart from custom prescriptions from your doctor) and treatments done in beauty institutes are generally ineffective.
There are medical treatments available to eliminate melasma and the pregnancy mask.
It is important to understand that this is a complex pigmentation disorder to treat, and relapses are frequent.
According to medical literature, the gold standard treatment is ablative laser. There are two types of ablative lasers : erbium and CO2. Doctor Romano uses the erbium laser. The treatment is performed by combining two modes : continuous (the entire pigmented area is treated superficially) and fractional (a percentage of the pigmentation is treated, with deeper penetration into the dermis).
Doctor Romano does not recommend treatment with intense pulsed light (IPL) or Q-switched laser, as they are largely ineffective and may worsen pigmentation.
The results of vascular laser are also modest.
Chemical peels use acids, such as glycolic acid or trichloroacetic acid, to exfoliate the superficial layers of the skin, thereby promoting cell regeneration and the removal of superficial pigment.
Depigmenting agents, selected based on the patient’s skin, are also included in the treatment. They work by dissolving pigment.
An assessment by an experienced doctor is essential. In fact, it is not always possible to treat melasma with a peel — it depends on the patient’s skin and the depth of the pigment. In some cases, peeling can actually worsen melasma. This is why it is crucial to consult a doctor who is familiar with this type of procedure.
Mesotherapy involves injecting vitamins, antioxidants and depigmenting agents directly into the middle layers of the skin. This treatment helps reduce pigmentation and revitalize the skin. However, it is a technique that enhances the results of laser and peels, but on its own, it is not an effective treatment.
For patients who prefer natural options before turning to medical or aesthetic treatments, there are several home remedies that may help reduce melasma pigmentation. Results vary and are not supported by scientific studies.
• Aloe vera : aloe vera contains compounds that promote skin regeneration and reduce dark spots.
• Apple cider vinegar : apple cider vinegar is another natural remedy for lightening dark spots due to its astringent and brightening properties. Dilute it with water and gently apply to affected areas using a cotton pad.
• Turmeric : turmeric, through its main active compound curcumin, is known for its anti-inflammatory and brightening properties. Mix a spoonful of turmeric with milk or honey and apply this paste to the skin to reduce pigmentation.
• Green tea : the antioxidants in green tea help reduce damage caused by free radicals, which are responsible for hyperpigmentation. Use cooled green tea bags on the skin.
The results of melasma treatment vary depending on the type of treatment and the severity of the pigmentation, particularly its depth.
Several sessions are required : 3 to 4 laser sessions and 5 to 7 peeling sessions. Annual maintenance sessions are recommended.
Brown spots gradually lighten and the skin regains a more even tone.
However, it is important to note that melasma is a chronic condition, and preventive measures — especially regular use of sunscreen — are essential to avoid recurrence.
| Type of consultation | Generally practiced rates |
|---|---|
|
Peel
|
Starting at 200 CHF per session |
|
Laser |
Starting at 200 CHF per session |
|
Mesotherapy |
250 CHF per session |
Patients are often satisfied with the results of melasma treatment, especially when combining several approaches such as depigmenting creams and laser treatment. They describe a significant improvement in the uniformity of their complexion and a boost in self-confidence. Frequent recurrences remain a challenge.
Le mélasma peut s’atténuer avec des traitements adaptés et une bonne protection solaire, mais il est souvent chronique et sujet à des récidives. Des soins dermatologiques comme les peelings, les lasers doux, ou les crèmes dépigmentantes ‘en appoint) peuvent significativement réduire les taches. Cependant, une routine de soins rigoureuse est essentielle pour prévenir leur réapparition.
Le mélasma se manifeste par des taches brunes ou grisâtres aux contours irréguliers, principalement sur le visage : les joues, le front, le nez, et la lèvre supérieure. Ces taches sont symétriques et apparaissent souvent sous l’effet des hormones ou d’une exposition solaire excessive.
Le mélasma est bénin et ne présente pas de danger pour la santé. Il s’agit d’un trouble pigmentaire esthétique, sans risque de complications graves. Cependant, il peut affecter la confiance en soi en raison de son impact visible sur la peau.
Il est déconseillé de s’exposer au soleil avec un mélasma, car les rayons UV stimulent la production de mélanine, aggravant les taches. Si l’exposition est inévitable, il est crucial d’utiliser une protection solaire à large spectre (SPF 50+) et de porter des accessoires protecteurs comme des chapeaux et des lunettes.
Bien que les traitements naturels soient moins puissants que les soins dermatologiques, certains peuvent aider à atténuer le mélasma. L’application régulière de vitamine C, d’aloe vera ou de masques au curcuma peut aider à uniformiser le teint. Cependant, la protection solaire reste le geste le plus efficace pour prévenir l’aggravation.
Le mélasma apparaît principalement sur les zones exposées du visage : les joues, le front, le nez, et la lèvre supérieure. Il peut aussi apparaître sur le cou et les avant-bras, surtout chez les personnes très exposées au soleil.
The services described on this website apply to Swiss territory; there are differences between countries.
Contact
Dr Valeria Romano
Pl. du Molard 5, 1204 Geneva, Switzerland
Monday to Friday, 9.30am to 6pm
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