March 26, 2009
Zapping off those brown blotches
Melasma causes brown patches of pigmentation to appear, usually on the face. POON CHIAN HUI finds out how they can be erased
Many women have melasma, a skin discolouration condition caused by hormonal changes, but not all of them know it.
'I would say that melasma affects three-quarters of Singapore women,' said dermatologist Joyce Lim, who owns Joyce Lim Skin and Laser Clinic. 'However, I've had patients who suffered for many years without knowing that they have it.'
She said the condition affects more women than men - nine in 10 people who get melasma are women.
Appearing as brown patches, melasma commonly affects the face. In women, the condition is linked to menopause but many experience it for the first time during pregnancy.
For this reason, melasma is often termed the 'mask of pregnancy', said Dr Lim.
Although public awareness of melasma is greater now compared to about five years ago - thanks to media reports and public forums on the skin condition - it may still be mistaken for other skin pigmentation problems, she said.
Some examples are freckles, acne scars, inflammatory pigmentation from procedures like chemical peels and post-injury pigmentation.
'The key difference is that melasma follows a pattern and the discolouration is more symmetrical,' said Dr Lim.
Melasma develops in three distinctive patterns - the centrofacial (chin, nose and forehead) pattern is the most common, followed by the cheeks and, lastly, the jawline.
Asians are more susceptible to the condition, as well as Latin Americans. This is because their skin produces more melanin - pigments that cause skin colour to darken, said Dr Lim.
'Most women try to treat it themselves by using whitening products sold in pharmacies,' she said. 'However, most of these do not contain the active ingredients that fade melasma, like hydroquinone and retin-A.'
Ms L. Li, who is in her early 50s, had taken that route. 'I had brown spots on my cheeks when I was about 40 years old,' she said. 'I didn't know it was a medical condition and I also had no idea where to seek treatment then.'
She resorted to over-the-counter whitening products, to no avail. After living with the condition for more than a decade, she finally consulted a polyclinic doctor in January this year.
'My job requires me to be exposed to the sun and I was worried that the pigmentation will worsen,' said Ms Li, who works in the sales department of a company.
She was referred to a dermatologist who prescribed Tri-luma, a face cream that has to be applied once a day. She feels that the pigmentation is fading.
The other option to treat melasma is with laser. However, effects may not be permanent and subsequent laser treatments are needed if the pigmentation reappears.
It is possible to limit the extent of melasma. For one, use sunblock regularly, said Dr Lim. Sunlight makes the skin produce melanin and sunblock helps to prevent these pigments from forming.
In addition, use whitening products that contain soy or niacinamid as they help block the transfer of pigments to the skin surface, thus reducing the appearance of spots, she said.
9 in 10 people who get melasma, a skin discolouration condition, are women