Melasma: what it is and why it matters in the assessment
Quick facts
- Definition
- Chronic hyperpigmentation, in brownish patches, usually symmetrical, on exposed areas of the face.
- Associated factors
- Sun, hormones, genetic predisposition and skin inflammation.
- Characteristic
- Tends to recur; control is ongoing.
- Relevance in HOF
- Heat, light and inflammation can make it worse; the plan needs caution and, sometimes, a referral.
Melasma is a pigmentation disorder characterized by brownish patches, usually symmetrical, on the forehead, cheekbones, upper lip and temples. It is more common in women of childbearing age, but can occur in men and at other ages. It is not a serious disease, but it is very bothersome and hard to control.
What usually triggers or worsens it?
Melasma is multifactorial. The main elements cited are:
- sun and visible light exposure, which stimulate pigment production;
- hormonal influence, as with the use of certain contraceptives and during pregnancy;
- family predisposition and more pigmented skin types;
- heat and local inflammation.
Skin with melasma is very reactive. Any inflammatory stimulus, such as from some procedures, can reactivate the pigment. That is why a history of dark patches is a mandatory question in the medical history.
Why does HOF need to care?
Because the patient's plan often combines injectables and technologies. Fillers and toxin have little direct relationship with melasma, but other resources call for care:
| Resource | Care with melasma |
|---|---|
| Intense pulsed light | Heat and light can worsen it; assess the indication |
| Fractional laser | Inflammation can reactivate it; depends on type and parameters |
| Microneedling | Inflammation and post-procedure sun protection need attention |
| Chemical peel | The choice of agent and skin preparation are decisive |
The table does not replace assessment: each resource has variations, and the decision belongs to the professional who uses them.
How do you handle it at the consultation?
Melasma calls for a frank conversation: it is a condition to be controlled, not cured, and daily sun protection makes a difference. Avoid promises of "permanent lightening". If the patient has active melasma and wants skin procedures, consider referring them to a dermatologist to stabilize the condition first.
In Harmy
The app does not assess pigmentation or spots: the prompt forbids skin retouching, and the projection changes only the marked areas by volume in ml. Melasma, if present, stays the same in the "After" image. The frontal photo can serve as a record of the skin on that day, but not as a way to track pigment.
Also called: chloasma, "pano" (popular term in Brazil).
Frequently asked questions
Does melasma prevent facial harmonization?
In general it does not prevent filler or toxin. The greater care is with light and heat technologies and with procedures that cause inflammation. The approach is assessed case by case by a qualified professional.