Are sunscreens efficient in melasma?

  • 15min
  • May. 2022
  • Supported By
    • La Roche-Posay

Melasma is a commonly acquired hyperpigmentation on sun-exposed areas.
It occurs more frequently in skin types IV–VI and is prevalent in Hispanic, Asian and African-American women.
The pathogenesis of melasma is not completely clear, but genetics, ethnicity, hormonal change and cumulative skin sun damage are implicated in its origin.1,2

How to protect melasma patients?5


Applying a suncare product combining a UV sunscreen with 4% of hydroxyquinone (HQ) for 8 weeks on melasma lesions reduces MASI score by 75% on average (2 mg/cm2 applied every 2 to 3 hours between 8am to 5pm) and improves physician satisfaction from good to excellent.



What's to be done in practice currently?


Unrecognized exposure to visible light might interfere with treatment depigmenting effects, or might induce recurrence after solar exposure despite conscientious UV-only sunscreen application.5



What about melasma during pregnancy?


Pregnancy is a period of hormonal changes that encourages melasma appearance. Because this hyperpigmentation is aggravated by sun exposure, it is necessary to prescribe external sunscreen to pregnant women.

Bibliography

  1. Ortonne JP, Arellano I, Berneburg M et al. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol 2009; 23:1254–1262.
  2. Hernández-Barrera R, Torres-Alvarez B, Castanedo-Cazares JP, Oros-Ovalle C, Moncada B. Solar elastosis and presence of mast cells as key features in the pathogenesis of melasma. Clin Exp Dermatol 2008;33:305–308.
  3. Kaye ET, Levin JA, Blank IH, Arndt KA, Anderson RR. Efficiency of opaque photoprotective agents in the visible light range. Arch Dermatol 1991;127:351–355.
    View the link to abstract
  4. Mahmoud BH, Ruvolo E, Hexsel CL et al. Impact of long-wavelength UVA and visible light on melanocompetent skin. J Invest Dermatol 2010;130:2092–2097.
    View the link to text
  5. Castanedo-Cazares JP et al. Near-visible light and UV photoprotection in the treatment of melasma: a double-blind randomized trial. Photodermatol Photoimmunol Photomed. 2014 Feb; 30(1):35-42.
  6. Liebel F, Kaur S, Ruvolo E, Kollias N, Southall MD. Irradiation of skin with visible light induces reactive oxygen species and matrix-degrading enzymes. J Invest Dermatol 2012;132:1901–1907.
  7. Kleinpenning MM, Smits T, Frunt MH, van Erp PE, van de Kerkhof PC, Gerritsen RM Clinical and histological effects of blue light on normal skin. Photodermatol Photoimmunol Photomed 2010;26:16–21.
  8. Silpa-Archa N, Kohli I, Al-Jamal M, Hamzavi I. Automated Melasma Area and Severity Index scoring. Br J Dermatol. 2015 Jun;172(6):1476.
  9. American Academy of Dermatology’s : Melasma: Tips to Make It Less Noticeable available at : https://www.aad.org/public/diseases/color-problems/melasma#tips
  10. Lakhdar H, Zouhair K, Khadir K, Essari A, Richard A, Seité S, Rougier A. Evaluation of the effectiveness of a broad-spectrum sunscreen in the prevention of chloasma in pregnant women. J Eur Acad Dermatol Venereol. 2007 Jul;21(6):738-42.
  11. Khadir K, Amal S, Hali F, Nejjam F, Lakhdar H. Les signes dermatologiques physiologiques de la grossesse. Ann Dermatol Venereol 1999; 126: 15–19.