Both hyperpigmentation and melasma cause darkened areas of skin to appear on the face, and sometimes, the forearms. The dark patches typically develop on the upper lip, on the nose, and in symmetric areas around the cheeks and eyebrows and can be grayish, brown, or tan. The unique symmetry of melasma distinguishes it from other conditions that cause the darkening of the skin. Both men and women can develop melasma, though it is much more common in females, especially in pregnancy and menopause. It can also be caused by sun damage, and existing patches of melasma can be aggravated or darkened by sun exposure. Though sun exposure does play a part in melasma, it seems to be more common in individuals with darker complexions than those with pale skin. If you have melasma and are frustrated with your appearance, consider scheduling a consultation at Pacific Skin and Cosmetic Dermatology San Francisco. Dermatologist Dr. Tracy Evans and her professional medical team can evaluate your condition and prescribe a number of treatments that can help reduce the visibility of this cosmetic condition.
Also categorized as darkening areas of the skin, hyperpigmentation can have several different causes. Often linked to spending excessive time in the sun without sunscreen, hyperpigmentation may need to be treated with advanced laser treatments. Other common causes of hyperpigmentation can include acne, inflammation, and other skin injuries. At Pacific Skin and Cosmetic Dermatology San Francisco, Dr. Tracy Evans can evaluate your skin and determine the best course of treatment for your hyperpigmentation issues.
"Dr. Evans has performed Mohs surgery on my face twice and I could not be happier with the results. For the past couple decades, I have spent almost every Summer in the South of France because I have family and friends there. Of course it is a sunny place with lots of gorgeous beaches and other outdoor activities. I guess I got a little too much sun exposure on these trips, especially since I have fair skin and blue eyes. When I first found out I had a basal cell spot on my face I was very upset, but Dr Evans and her staff are absolutely amazing!!! I had never had any surgery on my face and I was worried about it, but I truly felt I had the kind of empathy and care that you would get from a family member or a great friend, from Dr. Evans and everyone else on her team. Dr. Evans did such a great job on both surgeries and they have healed so well, so much so that no one even notices that I have had two surgeries on my face. I have been going to her office for years now with regular skin checks and I have to say I am extremely impressed with the entire staff. In addition to the Mohs surgery, and after I had basal cell a second time, I decided to get Fraxel Laser done at Dr. Evans office. A lot of people do this for cosmetic reasons, but I did it because I found out that Fraxel can help reduce the chance of getting basal cell in the future. As a guy, I did not see myself spending thousands of $’s on laser for my face the first time, but after I got the 2nd basal cell on my face I decided it was worth the money if it reduced the chance of more basal cell in the future. I was very pleased with the Fraxel procedures and I have not had another basal cell issue since I had it, so I am very happy with the decision. The Fraxel laser procedure also evened out the toning on my face, so that was great as well. I highly recommend the Fraxel Laser to anyone who wants to potentially reduce the chance of basal cell, and I also have been taking Nicotinamide (a special form of vitamin B) which can also potentially reduce future basal cell issues, and I use a DNA enzyme repair cream at night which reduces the chance of basal cell. As I said before, I have not had basal cell since I had the Fraxel and I think taking Nicotinamide and using the DNA enzyme repair cream all have helped. After all this I realize how important skin care is and I am grateful that I got such great care. Most of my friends never go to a dermatologist and have an ignorance is bliss attitude, but with Dr. Evans and her amazing team, I am much more aware of how important it is to get regular checks and what can be done to maintain my skin going forward. My skin looks great and people think I look much younger than my actual age. One final point: I also have a couple friends that have HMO insurance that also have had basal cell. They have had surgeries at their HMO and I can tell you the care and the results they received are not even close to the care and outstanding results I have had with Dr. Evans. In some cases, the HMO made my friends wait a long time before they could even get the Mohs surgery and they also made mistakes, and their results in terms of scarring and healing were not the best. There is no way I would trust an HMO to do this surgery. At this point, I would only trust Dr. Evans with something this important. Thanks to Dr. Evans, Clarence, Shantelle, Kirstie, Danielle, Leslie, and the entire team! You all have helped me in a difficult situation more than once and I got through it as if nothing ever happened because of your amazing care and skills!"- E.R. / Yelp / Sep 25, 2021
"I want to write this review for Dr Evans’ staff and specifically for Krystal and Ava. I have been treated there 4 times this year. Each time I go I feel like my health and happiness is the most important thing in the world to both medical and administrative staff. I am not just the next person in their busy day that needs treatment and a means for the practice to make money. I am made to feel the same way as when I fly first class or stay in a world class hotel. The entire experience from the time I walk in the door until I walk out again is unlike anything I have experienced at any doctor or dentist or any medical facility. They are professional and compassionate with a great "bedside" manner. I am cared for as a patient and valued as a human each visit."- S.G. / Yelp / Sep 01, 2021
"Dear Tracy Evans M.D. Thank you_Thank you_Thank you. For your amazing expertise and talents. I could not be happier with my care. Everyone on your staff is so competent and awesome. So grateful, Deb Protheroe"- D.P. / Google / Jul 11, 2021
"Excellent, thorough medical care for the skin. I appreciate the fact that Dr Evans monitors my skin every 6 months for medical issues and catches anything amiss early. Knowledgeable staff to help with skin care products after medical needs met. Beautiful relaxing spa like waiting area."- B.F. / Google / Jun 11, 2021
"I was in desperate need of a quick remedy to extract my pores and hydrate my face. Mallory recommended the hydrafacial treatment for me. The whole treatment was quick, only taking about 30 minutes, and very affordable with NO down time! Mallory was an absolute gem! Prior to the treatment, she explained the process and made sure I was comfortable. I would highly recommend Dr. Evans team at Pacific Skin Dermatology. Can’t wait for my next treatment!"- K.K. / Yelp / May 30, 2021
The exact cause of melasma is unknown. Experts believe that the dark patches in melasma could be triggered by several factors, including hormone fluctuations, a family history of melasma, anti-seizure medications, and other medications that make the skin more sensitive to ultraviolet (UV) light. Darker skin seems to be more prone to developing melasma. Overexposure to sunlight is considered the leading cause of melasma, especially in individuals with a genetic predisposition to this condition. Clinical studies have shown that individuals typically develop melasma in the summer months when the sun is most intense. In the winter, the hyperpigmentation tends to be less visible or lighter. Pregnancy hormones also seem to be a trigger, as around 50% of women develop melasma while pregnant.
Melasma is characterized by symmetrical discoloration or hyperpigmentation primarily on the face. However, some patients do have melasma on the forearms and neck area. Three types of common facial patterns have been identified in those with melasma:
- Centrofacial (center of the face) – hyperpigmentation on the forehead, upper lip, nose, and chin
- Malar (cheekbones) – dark patterns on the upper cheeks
- Mandibular (jawbone) – discoloration along the jaw
There are several options for treating melasma, but the method Dr. Evans will choose will depend on factors, like your skin type and how long you've had melasma. Dr. Evans has developed her own unique treatment plan for melasma, which she may determine is a great option for you. There are also a variety of medical-grade topical creams, gels, or lotions that can be used to exfoliate and lighten the skin. Dermatology resurfacing treatments, such as microdermabrasion, chemical peels, or fractional laser procedures, which remove old skin and promote regrowth, have also been successful. Another option is intense pulsed light therapy or IPL. Unlike lasers, which use intense, focused light, IPL is intense broadband light so the recovery time is briefer. Improvements usually last the longest when the patient implements good sun protection and skin care.
Get a Professional Diagnosis
While melasma is a very common skin condition that many women deal with, it can be tricky to treat. There are many over-the-counter remedies available, but using the wrong one can ultimately make your melasma darker. If you have experienced this problem or are simply fed up with OTC creams not working as advertised, it is time to see a professional dermatologist. Schedule your consultation with Dr. Tracy Evans or one of her experienced physician assistants at Pacific Skin and Cosmetic Dermatology San Francisco to start your journey back to an even skin tone.