Distinguishing between hyperpigmentation and melasma can often be challenging as exhibit similar symptoms on the skin. Hyperpigmentation and melasma are two different skin conditions, however, they share some common causes.
What is hyperpigmentation?
Hyperpigmentation is an umbrella term for any type of skin darkening in any part of the body, mostly seen on the face but can also be seen in other parts of the body,” says Dr Seema Oberoi Lall, consultant dermatologist, C K Birla Hospital, Gurugram.
She explains that there could be many reasons for hyperpigmentation. Hyperpigmentation can occur due to various reasons like injuries, burn scars, pimples, rashes, or acne, that leave a mark. Tan, freckles and moles can also manifest as pigmentation. Among this list of causes, melasma pigmentation is one example.
What is melasma?
“It is a type of pigmentation which commonly happens on the face. And although anyone can get it, it is more common in women,” says Dr Shikha Trivedi, a dermatologist based in Ranchi. Melasma occurs as a brownish pigmentation on both sides of the face, common areas being the cheeks. It can also appear on the temples, forehead, and upper lip, she adds.
While melasma is characterised by discolouration of the skin, it stands out from other forms of hyperpigmentation due to its distinct causes and appearance.
What causes melasma and hyperpigmentation?
Dr Lall and Dr Trivedi clarify that melasma is hyperpigmentation but not all instances of hyperpigmentation are melasma. There are distinct reasons for both. Both these conditions have unique underlying causes. Melasma, for instance, can have genetic factors, with some individuals inherently predisposed to darker skin tones. Moroever, certain racial backgrounds, such as Asians, may have a higher susceptibility to melasma due to naturally darker skin. Melasma is influenced by numerous other factors, including:
- Exposure to sun and similar rays
- Blue light from gadgets like screens, TV, computer or mobile
- Reflected sunlight from the windows and infrared lights that come from the fire while cooking
- Hormonal changes, mostly in women who are on oral contraceptives or post-pregnancy (Men too can get melasma due to hormonal changes)
According to experts, hyperpigmentation is a broad term for any darkening of skin, and melanin is the major driver.
Experts, trained to discern and distinguish between melasma and other hyperpigmentation conditions, rely on specific markers and characteristics. “We can easily identify whether the condition is melasma or other sort of hyperpigmentation like pigment contact dermatitis or lichen planus pigmentosus, which can also look like hyperpigmentation,” says Dr Lall.
Experts generally identify the condition with the naked eye, however sometimes they may also use tools such as a dermascope (a hand-held microscope) and wood lamps with specialised lighting. “These tools help us to assess the depth of pigmentation,” she adds.
The skin has two layers—epidermis (upper layer) and dermis (lower layer). A proper diagnosis is made to initiate and plan the treatment and the tools or gadgets help reflect how deep the condition is. Usually, superficial pigmentation or melasma responds faster to treatment than the deeper dermis melasma.
Managing melasma and hyperpigmentation
Dr Trivedi emphasises that all skin conditions are treatable and there are different treatments for every skin pigmentation condition.
She adds that even though melasma pigmentation is slightly stubborn, it is treatable.
“On an average, 80-85 per cent of individuals with any kind of hyperpigmentation respond well to the treatment with little to no observable skin darkening post-treatment,” says Dr Trivedi. While undergoing the treatment, it is important to remember that it does not get worse, and one does not have to conceal it all the time.
Twenty per cent of the individuals may have stubborn melasma where the dark patches do not lighten despite lengthy treatment and another 20-30 per cent may show no signs of it within three to six months after treatment. The remaining 60 per cent show good results, however there might be some shadows still present, adds Dr Lall.
Prevention and home remedies
Experts say that there may be unsaid factors causing melasma or pigmentation, however, one can adopt some skincare protocols to reduce the risk. Here are some by Dr Lall.
- Avoid doing any sporting activities like walking, jogging, swimming in broad daylight.
- Wear full-sleeved clothing, a hat, cap, scarf, or use an umbrella to protect yourself from direct sunlight exposure on exposed areas.
- Avoid or limit sitting near glass windows where broad and harsh sunlight comes in or gets reflected.
- Use sunscreen of minimum SPF 30 or higher, based on the skin type. Ensure that the sunscreen also provides PA+ protection to shield against UVA rays.
- Reapply generous amount of sunscreen after four to five hours.
- Women on oral contraceptives or medications to treat hormonal imbalance should speak with the gynaecologist to know if they can trigger melasma.
- Include vitamin C-rich food in your diet. Your doctor may also recommend using customised skincare products before, during, and after treating your pigmentation condition.
Experts suggest three things to keep in mind for melasma pigmentation and hyperpigmentation
- Proper diagnosis: Pigmentation might look the same but can require different treatments. Always remember to get it diagnosed with a dermatologist and avoid acting beforehand. Few conditions like fungal infections over any body area or recurrent acne are easy to treat, provided it is diagnosed by the doctor and treated accordingly.
- Give yourself time: Many women develop melasma post-pregnancy, post-abortion, during pregnancy or after normal delivery. One should follow good sun protection measures. In some cases, the condition may naturally improve within six months. Consult a doctor before using any skincare product. Your doctor will customise a treatment plan if the pigmentation does not improve significantly on its own.
- For every condition, there is a solution: many pigmentary conditions which were considered untreatable a few years back are now easily treatable with new innovations, newer technologies, and treatment options. Lasers, medical-grade peels, mesotherapy, and medifacials, are some of the options that help tackle pigmentation efficiently. It is always recommended to reach out to experts before opting any.