Melasma is a most common skin worry among men and women especially in people of Asian or African origin and it is a type of hyperpigmentation that causes small brown-black patches on the face. Dark skin such as Hispanic, Asian, African and Middle East descent are more susceptible to melasma.
In an interview with HT Lifestyle, Dr Rinky Kapoor, Consultant Dermatologist, Cosmetic Dermatologist and Dermato-Surgeon at The Esthetic Clinics, revealed, “Among the many factors that are believed to lead to melasma include thyroid gland irregularity, exposure to sunlight, genetic factors, pregnancy, use of oral contraceptive pills, cosmetic use, and epilepsy drugs. Men are equally affected by melasma but hormonal imbalances do not factor in the causes. The appearance of the black-brown patches of melasma often leads to cosmetic and social stigma. many studies have been conducted to find out the connection between melasma and the thyroid and it has been indicated that an under-active thyroid gland i.e., hypothyroidism often leads to stubborn melasma patches on the skin. This is because of the disrupted hormone levels.”
She shared, “The main function of the thyroid gland (located in the neck) is to regulate the energy levels of the body and the metabolism. Reduced function of the through gland causes hormonal disturbances which trigger increased estrogen levels. This in turn leads to extra melanin production on the skin leading to melasma spots. Another side effect of thyroid malfunction is that the lack of this hormone makes the immune system weak which in turn causes skin inflammation leading to the exacerbated appearance of melasma as the melanin-producing cells produce more pigment.”
Treatment for thyroid-induced melasma
According to Dr Rinky Kapoor, the treatment for melasma has two parts. She explained, “The first part is to treat the hormonal levels and bring them to normal. Treating the underlying hypothyroidism is the best way to control melasma and in many cases, it eventually does go away.” Treatment for hypothyroidism includes –
- Hormonal replacement therapy medications which should be taken as prescribed and you should work with your doctor to adjust the dosage.
- Lifestyle changes which include diet modifications and regular exercise routine.
Once the thyroid levels are under control the dermatologist can work on treating the melasma. The common options for treating melasma and improving the appearance of melasma, as recommended by Dr Rinky Kapoor, include –
1. Topical Treatments: These can include hydroquinone, tretinoin, corticosteroids, azelaic acid, and kojic acid. These agents work by lightening the skin and reducing the production of melanin. Some products may contain a combination of these ingredients to enhance effectiveness. They are normally included in your regular skincare routine.
2. Procedures: Various dermatological procedures can help improve the appearance of melasma. These include:
a) Chemical Peels: This involves applying a chemical solution to the skin to exfoliate the top layers. As the new skin layer heals on the surface, there are reduced signs of melasma and a more even-toned texture.
b) Microdermabrasion: This is an exfoliation procedure designed to remove the top layer of the skin and improve its texture and tone greatly.
c) Laser Treatment: Certain types of lasers, such as Q-switched lasers and fractional lasers, can target melanin help break up the melasma spots, and help lighten the dark patches associated with melasma.
d) Intense Pulsed Light (IPL) Therapy: This treatment uses broad-spectrum light to target the pigmented areas of the skin, effectively reducing the appearance of melasma.
3. Sun Protection: Since exposure to sunlight can worsen melasma, using broad-spectrum sunscreen with a high SPF (30+++) is essential. Sunscreen should be reapplied every two hours, especially when spending prolonged periods outdoors. Additionally, wearing protective clothing, and sunglasses and using wide-brimmed hats can provide extra protection.
4. Cosmetic Camouflage: Makeup can be used to cover the affected areas, providing temporary relief and helping to improve the appearance of melasma.
5. Combination Therapy: Some cases of melasma may require a combination of topical treatments, procedures, and strict sun protection for effective management. This approach is often tailored to the specific needs of the individual and is best determined in consultation with a dermatologist.
Dr Rinky Kapoor concluded, “Melasma can be challenging to manage but understanding the relation between thyroid and melasma helps a lot in managing this condition. Dr. helps in figuring out the correct treatment by tailoring the solution according to the skin type, extent of melasma, age of the patient and the underlying condition to help the patient achieve clear, glowing, and healthy skin.”