Twacha Aesthetic Clinic


Melasma Treatment

The pigmentation condition of the skin that primarily affects women, particularly those with darker skin tones, is melasma. Melasma, also known as “chloasma” or the “mask of pregnancy,” is a chronic skin disorder that commonly affects women between the ages of 20 and 40 or after having childbirth. Dark brown, tan, or gray areas of skin that are blotchy, bilaterally pigmented, and present on the face are its main characteristics. Dark brown, tan, or gray areas of skin that are blotchy, bilaterally pigmented, and present on the face are its defining features. In males, this skin disease is less common. Melasma occurs in 3 distinct location patterns:

  • Central face
  • Cheekbones
  • Jawline

Melasma is acquired hyper melanosis, seen primarily in women in sun-exposed areas. Other areas of the body often exposed to sunlight may develop this condition as well. In fact, Melasma can affect any area of your skin that is exposed to the sun. Most people get this skin problem on their nose bridge, cheeks, chin, upper lip, and forehead.

Avoiding sunlight and protecting your skin from sun damage is absolutely crucial for preventing melasma from developing further, as well as for maintaining the results of treatment. In addition to avoiding sun exposure, stopping your use of sunscreen with a high SPF level (50 or higher) may also prevent melasma development. Yes, but use makeup that includes sunscreen, and be aware of any products that might worsen your melasma by irritating the skin.


Melasma symptoms/clinical characteristics:

Bilateral, asymptomatic, light to dark brown macules that tend to be freckles or bigger discolored patches with irregular boundaries can be seen on the skin of melasma patients. These flat, discolored spots normally appear symmetrically on the face and are discolored. They are not painful, itchy, or burning.

Melasma can be one of three forms depending on the amount of melanin in the skin:

  • Epidermal melasma- These are bordered, dark-brown areas of skin. They show sporadic islands of brown reticular networks with dark granules under dermoscopy.
  • Dermal melasma- These have ill-defined borders and range in color from light brown to blue-gray. In reticulonodular patterns, arciform structures, threadlike red lines, or skin patterns, can be seen via dermoscopy (as in the Telangiectasia condition).
  • Mixed melasma (the most common type)- These patches range in hue from light to dark brown to blue-gray.

What triggers melasma?

Melasma’s precise cause is still a subject of research. However, a lot of scientists think that specific elements have a role in melasma formation. The likelihood of developing melasma increases with the number of these triggers a person has. However, it can also manifest in certain persons with no apparent cause.

Internal factors

  • Genetics – Many different inherited genetic factors contribute to susceptibility to melasma.
  • Melasma can run in families – research has shown that nearly half of women with the condition have a family member who also has it. Melasma affects the majority of identical twins.
  • Hormones – This well-known and typical melasma trigger. Some people’s high oestrogen levels may be a contributing factor. Tyrosinase, an enzyme that produces colour, is known to be produced in greater quantities by oestrogen in the body. Additionally, those who have melasma have more progesterone receptors in the parts of their skin that are afflicted, making them more sensitive to higher progesterone levels. Therefore, melasma can be brought on by pregnancy and thyroid conditions that alter the quantities of these hormones.

External factors

  • Sun exposure and tanning beds – The most frequent causes of melasma are ultraviolet rays from sunshine or the UV light produced by tanning beds because they promote the skin’s development of melanin. It is well known that exposure to UV light triggers the release of specific “pro-inflammatory” molecules, which in turn stimulate the skin’s melanocytes to create too much melanin. Skin tans as a result of this increased synthesis of pigment, but it can also exacerbate or intensify melasma. As a result, it is clear that melasma flares tend to occur more frequently in the summer and may lessen slightly in the winter.
  • Certain skin-irritating products – Certain scents, soaps, and cosmetics are skin irritants that can cause skin irritation. By using these items, those who have melasma because of their genetics, gender, or kind of skin may experience inflammation, which may lead to a flare-up of their condition. Avoid using toiletries, perfumed goods, or cosmetics that include chemicals since irritation might result in the skin becoming even darker due to a phototoxic reaction.
  • Antiseizure medications – These include certain drugs that prevent an individual from having seizures.
  • Oral contraceptives (birth control pills) – These contain estrogen and progesterone hormones and their intake can lead to skin pigmentation.
  • Stress – It leads to a rise in cortisol levels which further influence the amount of estrogen in the body.


The usual skin look, such as dark face pigmentation, can be quickly used to identify melasma. By using Wood’s light or a blacklight during a visual skin examination, dermatologists at Zennara frequently identify this skin condition (300-400nm). To rule out any other potential causes of localised hyperpigmented skin, the dermatologist may in rare cases need to do a skin biopsy.


Best Melasma Treatment in Nagpur at Twacha Aesthetic Clinic

Treatment for melasma can assist in minimizing dark patches’ appearing and preventing their recurrence. The best outcomes are obtained by combining various strategies.

1. Topical therapy: According to reports, a formulation including hydroquinone (a tyrosinase inhibitor), a moderately potent topical steroid, and tretinoin can clear up 60–80% of melasma. Ascorbic acid, kojic acid, azelaic acid, methimazole, tranexamic acid, cyste-amine cream, and soybean extract are further treatments that have been shown to be beneficial.

2. Chemical peels: Melasma can be treated with chemical peels, which exfoliate the skin to remove the top layer of pigmented skin. It is a minimally invasive procedure where the skin is treated with acidic solutions to encourage the creation of new skin and peel the old skin off. The following chemical peels are frequently used to treat melasma:

  • Azelaic acid– It lowers melasma in those with dark skin types by 15-20% thanks to its anti-melanin and disinfecting characteristics. It works on melanocytes that are extremely active, saving areas where melanocytes are functioning.
  • Glycolic acidAlpha-hydroxy acid glycolic acid exfoliates the skin without causing burns, scabs, or redness. In order to treat melasma, dermatologists typically apply glycolic acid lotion or gel to the skin for one to five minutes at a concentration of 30% to 70%. For improved effects, it can be coupled with other topical treatments as salicylic acid, kojic acid, azelaic acid, or hydr-oq-uinone. After a few weeks of the initial treatment, a series of four to six weekly treatments might be necessary for the best outcomes.
  • Salicylic acid– a beta-hydroxy acid, is one of the most popular chemical peels since it is secure and well-tolerated by people with all types of skin. Dermatologists utilise salicylic acid peels with strengths ranging from 20 to 30% to treat epidermal melasma.

3. Laser and light-based techniques – Laser therapy is an excellent remedy for treating melasma. People with melasma that resists therapy look for it. There are numerous melasma therapies, including:

  • Intense Pulsed Light-Deep-seated excess pigment is removed by intense pulsed light, which targets the melanin in the skin. The risk of post-inflammatory hyperpigmentation is minimal.
  • Q-switched lasers – This form of non-ablative laser produces heat to encourage the creation of collagen as well as to selectively remove extra melanin by thermal energy without harming the surface of the skin.
  • Picosecond lasers – Laser pulsing at a frequency of one pulse every trillionth of a second is now conceivable because to the development of picosecond lasers. Due to the rapidity of these pulses, sound energy is produced instead of thermal energy. This has effects on how melasma lesions are removed. Recent studies on the effects of picosecond lasers have shown that melanin appearance in the epidermis is immediately reduced.
  • Fractionated laser – By eliminating too many melanocytes, which are the source of hyperpigmentation, fractionated laser technology also encourages the creation of collagen, giving the skin a healthier and younger appearance.

4. Mesotherapy- Micro-injecting antioxidants, enzymes, vitamins, plant extracts, and other all-natural compounds into the skin’s mesoderm is the process known as mesotherapy. It can aid in the body’s detoxification process, boost blood circulation, and rapidly reduce the appearance of melasma-related superficial wrinkles and tired-looking, dull skin. In order to achieve skin that looks healthy, it moisturises, tones, tightens, and rejuvenates the skin.

In addition to these treatments, Twacha also provides medical facials, microneedling, and growth factor to treat melasma.

Several precautionary measures
Melasma is a disease with a high rate of repetition or recurrence. However, avoiding certain situations in the first place can lessen the likelihood of recurrence:

  • Use sunscreen every day– ultraviolet radiation is one of the main causes of melasma. Daily usage of sunscreen is essential to preventing it. Use a broad-spectrum sunscreen that has an SPF of 30 or higher.
  •  Wear Outdoor Hats- Broad-bordered hats for the outdoors assist shield the face from the sun’s rays. whenever you are outside, keep an eye out for shade.
  • Soft Skincare- Use soft products that do not hurt or burn on your skin because those that irritate it can make melasma worse.
  • Water – Consuming enough water to remove toxins from the body, especially free radicals. Additionally, by maintaining cell hydration, the effects of UV exposure are more easily resisted by the cells.
  • Avoid any exposure to heat, including when cooking.



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