What does melasma look like and how is it diagnosed?

Melasma typically forms on the forehead, bridge of the nose, cheeks and above the upper lip, with patches of pigmentation usually brown to grey-brown in colour.

Although melasma does not cause any discomfort, it is often an annoying problem due to its high visibility. It causes distress because it can be difficult to cover with makeup, and necessitates the wearing of foundation to mask it.

Diagnosis of melasma
Very often, melasma does not look absolutely typical and there needs to be a high index of suspicion to ensure correct diagnosis to avoid treatments that will worsen the pigmentation.

At ENRICH, our specialist doctors will often use a device called a Wood’s lamp to investigate whether the pigmentation is, in fact, melasma, and if so, how deep the pigment sits within the skin.

Occasionally a skin biopsy is required to rule out any other cause for the pigmentation. In this situation, a tiny 1.5 mm to 2 mm piece of skin is removed and sent to the pathology laboratory for testing. This biopsy is performed using local anaesthetic so that it is a pain-free procedure.

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