Melasma and dark spot treatment in Medellín

Melasma, the “mask of pregnancy” and paño (its common name in Spanish) are all names for the same thing. The American Academy of Dermatology (AAD) describes it as flat patches, darker than your natural skin tone, ranging from brown to bluish gray, that usually appear on the cheeks, forehead, chin or above the upper lip. It's more common in women and in medium to dark skin tones. It isn't contagious, and it isn't a type of cancer. Among the things that trigger it or make it more likely, the AAD lists:

• Sun exposure.
• Pregnancy and birth control pills.
• Some medications that make your skin more sensitive to the sun.
• Tanning beds and thyroid problems.
• Being a woman of Latin heritage, or having family members with melasma.

A sun spot, a mark left by acne and melasma can look alike, but they aren't treated the same way. As the AAD explains, treatment depends on what's causing the spot, and if it comes from acne, the acne has to be under control first. According to MedlinePlus, from the U.S. National Library of Medicine, melasma is diagnosed by looking at the skin; sometimes a special lamp, called a Wood's lamp, is used to help guide treatment. That's why we don't diagnose it from photos or over WhatsApp: your doctor determines what type of spot you have when she examines you in person. Here's what happens at the consultation (in Spanish).

According to MedlinePlus, melasma treatment may include prescription creams, chemical peels and, when melasma is more severe, laser. Sun protection is what helps most to prevent it. At noon, your plan may combine:

• Prescription skin-lightening treatments.
• Chemical peels.
• Technologies such as laser, depending on your skin.
• Sun protection and at-home care every day.

What gets combined, and in what order, is up to your doctor, based on your type of spots and your skin. Results are gradual and, because melasma can come back with sun exposure or hormonal changes, the plan continues with maintenance.

There are times when the plan changes, or when it's better to wait:

• If you're pregnant, breastfeeding or trying to get pregnant, tell your doctor before you start. The AAD says to avoid hydroquinone and retinoids, such as tretinoin or products with retinol, during pregnancy.
• If you plan to keep using tanning beds: according to the AAD, they make melasma worse and can keep treatment from working.
• If you're hoping it will go away for good: melasma is controlled with consistent care and, according to the AAD, it can be stubborn even when you follow the plan.

Treating dark spots also has risks, including:

• Irritation: according to the AAD, if a product burns or stings, it's irritating your skin, and that can make the spots darker.
• With chemical peels, the AAD mentions redness, peeling and temporary darkening of the skin, and with medium and deep peels, lighter skin. In darker skin, if peels are done by someone without experience treating these skin tones, they can leave permanent changes in skin color.
• With laser: not every laser is right for every skin. It depends on the laser and on your Fitzpatrick skin type, which is why your skin is assessed first.

Before you start, your doctor explains the risks of each part of your plan.

What you do at home is also part of the treatment. The AAD recommends:

• Sunscreen every day, even when it's cloudy, on all skin not covered by clothing.
• Seeking shade and wearing a wide-brimmed hat and sunglasses with UV protection.
• Gentle, fragrance-free products.

While you're getting peels, sun protection has to be strict. For your consultation, bring a list of the products you use on your skin and the medications you take.