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Debunking Common Myths About Melasma

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:

Melasma on woman's face
  • Melasma is common in women between 20 and 50 years old.
  • A large population of women suffering from melasma is often caused by pregnancy.
  • Melasma is usually found around the cheeks and jawline.
  • Even though it is more much common in women, some 10 percent melasma sufferers are men.

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 also recommend chemical peels using salicylic acid or glycolic acid to remove the top layer of the skin to achieve a more even skin tone. Immediately after the treatment, your skin may be raw and sensitive, almost like a severe sunburn. Your skin will begin to peel after a few days. 

One of the most common treatments for melasma is to use lasers. However, you need to know that many lasers may make your melasma worse. For example, if your doctor uses a pigment laser meant for treating sunspots to treat melasma, it may worsen the condition. Laser treatments are generally expensive, and it is important to choose a doctor who has experience in treating melasma.

“Newer and more advanced laser technology such as PicoSure Laser is widely used by doctors to treat melasma,” says Dr. Siew. Through its targeted mode of energy delivery, PicoSure is able to reach the dermis to break down stubborn pigments.

Sylfirm, on the other hand, uses pulsed radiofrequency waves to generate electrothermal effect on the skin. Microneedles are used to introduce the RF energy into the skin to target the dark pigments.

Regardless of the treatments you opt for, you need to be fully aware that they don’t guarantee that melasma won’t come back, and some cases of melasma can’t be completely lightened.

Myth #2: Regular exfoliation can lighten melasma

Woman washing her face

Exfoliating the skin using a gentle scrub is a sure way to achieve brighter, smoother skin by removing dead skin cells. However, using an exfoliator does not help to treat melasma. 

Melasma is caused by overactive melanocytes in the skin, causing it to create too much dark pigments. These dark pigments are not found in the superficial layers of the skin. Hence, using an exfoliator does not improve the condition.

Myth #3: There is only one type of melasma and the same treatment should work for everyone.

Unfortunately, that is not true. There are 3 main types of melasma, namely epidermal, dermal, and mixed.

Epidermal melasma is typically characterized by dark brown patches that have defined borders. Such melasma often respond well to chemical peels and laser treatments because they are the most superficial with an increase in skin pigments in the top layer of the skin.

Dermal melasma is characterized by light brown or bluish patches that may not have a clear border. As they tend to be in the deeper layers of the skin, they are very difficult to treat as they don’t respond well to treatment.

Mixed melasma is simply a combination of epidermal melasma and dermal melasma. This is also the most common type of melasma diagnosed by doctors. It is characterized by a combination of light and dark brown patches. 

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One of the simplest and most effective ways to prevent the worsening of the condition is to protect the skin from direct sun exposure. UV rays triggers the production of melanin in the skin, darkening the pigments on the skin.  

To manage melasma, Dr. Siew urges people with melasma to be more disciplined with sun protection. “Choose a broad-spectrum sunscreen of at least SPF50 about one hour before you are exposed to the sun,” he added. Be sure to reapply every two hours. 

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