Debunking Common Myths About Melasma Treatments
Our grandmothers have freely dished out advice about almost everything in the world. From what to eat, what to avoid, what will cure fever, headaches, and what will kill you, our grandparents seem to have a strong opinion about them. We don’t mean any disrespect, but grandmothers are not always right. Well, some of these make sense, but others are just old wives’ tales or myths. As children, we have been told that ulcers are caused by eating spicy food. It is true that spicy food may aggravate the condition, but there is no evidence to show that ulcers are caused by spicy food.
Many other practices are passed down for many generations so they can’t be wrong, right? Wrong. Before we clear the air and debunk some myths about melasma, here are some quick facts about it:
There are many myths surrounding melasma. We take this opportunity to debunk some of these myths and set the record straight. We speak to Dr. Siew Tuck Wah, Medical Director of Radium Medical Aesthetics, who tells us whether some common beliefs about melasma is accurate.
Myth #1: Melasma can be treated completely
Melasma is sometimes referred to as the “Mask of Pregnancy” because it is very common in pregnant women. It can appear very visibly during the time of their pregnancy. If the dark pigments were induced by pregnancy, it is likely to resolve on its own after delivery. For some, melasma may be stubborn and people can struggle with this condition for many years. In such cases, seeking medical help may be the best option. Your doctor may prescribe topical creams containing hydroquinone to lighten the dark pigments. You may be able to find over-the-counter hydroquinone creams, but these are generally very weak and will unlikely be effective to treat the condition.
Your doctor may recommend chemical peels with ingredients such as salicylic acid or glycolic acid as part of a melasma treatment plan. These peels work by gently removing the outer layer of skin to reveal a fresher, more even complexion. After treatment, your skin may feel raw and sensitive -similar to a sunburn – and will usually begin peeling within a few days.
Another widely used melasma treatment is laser therapy. However, not all lasers are suitable for melasma. In fact, using pigment lasers designed for sunspots may actually worsen the condition. Since laser procedures can be expensive, it’s essential to seek out a doctor who is highly experienced in melasma management.
According to Dr. Siew, advanced technologies such as PicoSure Laser have become popular for melasma treatment. The Pico Laser uses ultra-short pulses of energy to reach the dermis and break down stubborn pigmentation safely and effectively. Similarly, Dual Wave RF microneedling treatment like Sylfirm X offers another option. This procedure uses ultrafine microneedles to deliver RF energy deep into the skin, creating an electrothermal effect that targets dark pigments.
While these advanced melasma treatments can produce excellent results, it’s important to remember that melasma is a chronic condition. Results vary from patient to patient, and melasma may return over time. In some cases, the pigmentation cannot be fully removed, but ongoing treatment and maintenance can keep it well under control.
Myth #2: Regular exfoliation can lighten melasma
Exfoliating with a gentle scrub can help reveal brighter, smoother skin by removing surface dead skin cells. However, it’s important to note that exfoliation alone does not treat melasma.
Melasma develops when melanocytes – the pigment-producing cells in the skin- become overactive and generate excess melanin. These dark pigments are located deeper within the skin, not just on the surface. As a result, using an exfoliator may improve overall skin texture, but it will not significantly improve or lighten melasma.
Myth #3: There is only one type of melasma and the same treatment should work for everyone.
Melasma is classified into three main types: epidermal, dermal, and mixed.
Epidermal melasma presents as dark brown patches with well-defined borders. Because the excess pigment is concentrated in the top layer of skin, epidermal melasma often responds well to melasma treatments such as chemical peels and appropriately selected lasers.
Dermal melasma appears as light brown or bluish patches with less distinct borders. Since the pigment lies deeper in the dermis, these cases are more challenging to treat and typically respond less predictably to therapy.
Mixed melasma contains features of both epidermal and dermal types and is the most commonly diagnosed form. It shows a combination of light and dark brown patches and often requires a multi-modal treatment approach.
One of the simplest and most effective ways to prevent melasma from worsening is strict sun protection. Ultraviolet (UV) radiation stimulates melanin production and can darken existing pigments. As Dr. Siew advises, “Choose a broad-spectrum sunscreen of at least SPF 50 about one hour before sun exposure,” and be sure to reapply every two hours. Your doctor can help determine the melasma type and recommend a tailored treatment and maintenance plan. Regardless of the melasma treatment you choose to reduce pigmentation, one step you should never skip is applying a broad-spectrum SPF50 sunscreen.
