Brown spots on the face are undesirable by most people, especially women. We want our face to be beautiful, smooth and mark free at all times, with the option of wearing, or not wearing makeup on any given day. But sometimes it does not always happen that way and we end up with marks, bumps and spots. However, sometimes the skin changes as we age and this could be as a result of our genetic history, medications that may have been taken or sun exposure. A common condition that most women may notice is called Melasma or Chloasma.
Melasma is a common condition of various shades of light to dark brown discolored patches on the skin, mainly on the facial area of the upper cheeks, upper lip, forehead and chin usually in women of child-bearing age between 20 to 50 years. This condition is not commonly found on our male counterparts but it can be.
The real cause of this undesirable problem is unknown, but the melanocytes or pigment cells are to blame, because these cells are the ones to become very active -- increasing their melanin production. How light or dark the skin becomes can result in brown patches on the face. In addition to daily or intermittent sun exposure, medication that can make the skin become more sun sensitive, external hormones like birth control pills or hormone replacement therapy that are used in women going through menopause and internal hormonal changes that occur during pregnancy are also factors that play a significant role in its existence.
During the summer months when the sun's rays are really intense are the times when women with this problem either notice more appearing or notice their darkening or multiplication. However, in this region where we are blessed with sun and heat almost all year round, it can be problematic for some, worsening their problem. Women are very particular about their faces and notice a difference in texture, tone and color before anyone else.
Normally, this condition starts as a small light to dark brown spot anywhere on the face that with time can gradually become larger. If multiple spots are noticed, sometimes, they enlarge and the spots can join together forming a larger brown patch that causes us to freak out and want something done immediately. There usually is no itching, reddening, tenderness or swelling experienced on or around these patches, they are just unwanted.
How to prevent this from happening or worsening and what treatments are available.
Melasma is a chronic condition that can come and go. It gradually appears therefore it takes time to gradually go, but it has a good treatment outcome in cases for those people who are persistent and not discouraged with the treatment process and its slow clearance.
The first and most important part of treatment is sunscreen. The sun and its magnificent rays can stimulate the activity of the melanocytes or pigment cells to increase pigment production, worsening the spot or patch. Therefore, the application on a daily basis with a sunscreen of 30 percent or higher that has ingredients such as zinc oxide and titanium dioxide is recommended to block ultraviolet (UV) raysin turn reducing the amount of UV rays coming in contact with your skin.
Additionally, the usual sun protection gear should be used -- hats, sunglasses, umbrellas and clothes designed with sun protection materials. Besides those things that you can do for yourself, medical intervention by way of a dermatologist can be used. After consultation with the dermatologist, depending on the severity of the melasma, the following can either be done by itself as a single treatment or done in combination with each other.
Oral medication is an option, but if it causes a worsening of the condition then it needs to be discontinued. Additionally, the use of keratinolytics, which are peeling agents such as, retinoids, salicylic acid or glycolic acid that gradually remove the top layers of skin cells to encourage younger less pigment-active cells to emerge, gradually even toning the area. These are usually in the form of creams, gels or applied as chemical peels. However, mechanical techniques may also be required by way of microdermabrasions. Another option is with prescribed creams that suppress the activity of the pigment cells reducing the pigment activity hence producing less pigment and in turn lightening the spot or patch.
Melasma in some cases can resolve on its own, but if not, treatment options are available and as it took time to develop, it will take time to gradually clear with sometimes unexpected reoccurrences.

oDr. Rokeisha Clare-Kleinbussink studied at Cosmetology Cosmetic Training for Dermal Filler in London, UK and attended the Academy of Beauty Training for Laser and Microdermabrasion in Nottinghamshire, UK. She also attended the University of the West Indies School of Medicine and Cardiff University School of Medicine. She has a private practice at Roseona House of General and Cosmetic Dermatology and can be reached at www.roseonahouse.com or 422-2022.

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