​Melasma – Memphis Dermatologist
Melasma – also called Choasma – is a frequent skin condition which brings patients to a Memphis Dermatologist such as myself – because my own Dermatology practice – with Rheumatology and Dermatology Associates (8143 Walnut Grove Road, Cordova TN 38018: 1-901-753-0168: www.Rheumderm.com) is in the Sun Belt – and Ultraviolet light is one of the most common causes of Melasma. Let’s take a look at the causes of and treatment of Melasma – as new therapies are coming out of Dermatology research to offer hope for people with this condition.
First, Melasma is deposition of excess pigment in the skin, and it often presents on the face and neck, the arms and scalp. Causes can include hormonal changes in pregnancy, certain birth control pills, or certain conditions that cause irritation in the skin, such as Atopic Dermatitis (Eczema), Psoriasis, or Seborrheic Dermatitis, or even Acne.
Medication-related pigment deposition in the skin can be very similar in appearance to Melasma, so we generally start by taking a medication history. Many different drugs can lead into medication-related pigment deposition, including certain antibiotics such as tetracycline and minocycline, and especially certain oral contraceptives such as Birth Control Pills.
Dermatologists sometimes consider running lab testing on patients suspected of Melasma, to look at hormone balance, particularly at levels of DHEAS and free and total Testosterone, and sometimes at FSH and LH levels.
Sometimes Dermatologists are never able to identify the cause of Melasma, but fortunately we have a number of different options for treatment:
We often start Melasma management by talking with our patients about adequate sun protection and UV protection, particularly about the importance of using Broad-spectrum sunscreens daily, particularly those with an SPF rating of 50 or higher. There are many different options within sunscreens that meet these criteria, and one appealing choice that’s less likely to run into your eyes is Vanicream Sunscreen Sport SPF 50, a fragrance-free sunscreen based upon zinc oxide that is free of dyes, lanolin, formaldehyde, and sulfates.
Vanicream Sunscreen Sport SPF 50 is now available through Big River Silk™ Skincare, a hypoallergenic skincare products company of which I have been President since 2016 (www.Bigriversilkskincare.com) (2.5 oz: $17.95 plus applicable U.S. $5.00 shipping and handling ($10.00 Canadian).
Topical (meaning for use on top of the skin) over-the-counter or prescription bleaching agents such as Hydroquinone are often helpful for patients with Melasma. Over-the-counter options include Ambi and Porcelana, and Hydroquinone is also available as a prescription strength 4% product after seeing a Dermatologist. Progress with these products happens over months, not over days, so patience is the key to improvement.
Sometimes Dermatologists add nightly use of prescription Tretinoin (Retin A) cream or lotion, or even topical steroid creams or lotions. Another option is an oral prescription medication called Tranexamic Acid. Laser therapy available through cosmetic Dermatologists and certain Plastic Surgeons can sometimes be helpful, as can use of use of liquid nitrogen, though these options require multiple sessions of treatment.
Allergy Patch Testing – an option in my own Memphis Dermatology practice since 2004 - can sometimes be quite helpful in the identification of underlying allergic causes of Melasma. It involves placing a panel of known causes of Contact Dermatitis under patches on a patient’s back, and it generally involves returning to get the testing read about two and then four days after the patches have been placed. With Allergy Patch Testing, Dermatologists are generally searching for allergies to preservatives in cosmetics and toiletries, fragrances, and components of latex or certain metals like Nickel and Cobalt.
For more on Allergy Patch Testing, check out a short movie that my Dermatology practice sponsored for Youtube:
In addition to being a Cordova Dermatologist, I am the President of Big River Silk™ Skincare, focused on skincare products with lower risk of allergies for people of all ages, from babies to seniors, using a minimal number of chemicals, to minimize the risk of allergic reactions. We offer HypoShea Moisturizer Cream, free of fragrances, dyes, and propylene glycol, as well as HypoShea Oil, convenient for use after bathing or showering (1 oz: $7.97/2 oz: $12.95), and also a new preparation as of 2023: GlycoShea Facial&NeckLotion, a helpful Alpha Hydroxy Acid or AHA-containing product containing Glycolic Acid which can be used as a nighttime moisturizer.
All Big River Silk Skincare products are available at www.Bigriversilkskincare.com, or at our international headquarters, at 8143 Walnut Grove Road, Cordova, TN 38018, Monday-Friday, from 7:30 AM to 4:30 PM. Or you can call us at 1-901-753-0168. We do offer free shipping and handling or US orders above $40.00 ($70.00 Canadian). Otherwise, $5.00 shipping and handling for US orders/$10.00 Canadian. less
So if you or a family member has been suffering from a facial eruption or rash, consider getting into a Dermatologist’s office for an evaluation today. As a Cordova Dermatologist, I have been a member of the American Contact Dermatitis Society, offering Allergy Patch Testing since 2004. Of you can find a Dermatologist closer to you by going to the American Academy of Dermatology website, AAD.org, then plugging your zip code into the “Find a Dermatologist” tab. The bottom line? Seek Help Today.
George Woodbury Jr. M.D.
Rheumatology and Dermatology Associates
8143 Walnut Grove Road
Cordova TN 38018
1-901-753-0168