Definition of Dermal and Epidermal Melasma
Dermal melasma: Dermal melasma is a type of melasma that affects the deeper layers of the skin, specifically the dermis. It is characterized by brown or grayish-brown patches that are less defined than those in epidermal melasma. Dermal melasma is caused by the overproduction of melanin by the melanocytes in the dermis. Unlike epidermal melasma, dermal melasma is more difficult to treat due to its deeper location.
Causes of dermal melasma can include hormonal changes, sun exposure, genetics, and certain medications. It is often seen in women during pregnancy or while taking oral contraceptives. People with darker skin tones are also more prone to developing dermal melasma.
Symptoms of dermal melasma include brown or grayish-brown patches on the cheeks, forehead, nose, and chin. The patches are less defined than those in epidermal melasma and may have a blue-gray or slate color. They may also be accompanied by a slight bumpiness or roughness to the skin.
Diagnosis of dermal melasma can be done through a visual examination by a dermatologist or other healthcare provider. They may also use a Wood’s lamp or perform a skin biopsy to confirm the diagnosis.
Treatment options for dermal melasma can include topical medications such as hydroquinone, tretinoin, and corticosteroids. In some cases, chemical peels, microdermabrasion, or laser therapy may be recommended. It is important to note that treatment for dermal melasma may take longer and be less effective than treatment for epidermal melasma due to the deeper location of the pigmentation. It is also important to use sunscreen and avoid excessive sun exposure to prevent further darkening of the skin.
Epidermal melasma: Epidermal melasma is a type of melasma that affects the outermost layer of the skin, specifically the epidermis. It is characterized by brown or grayish-brown patches that are well-defined and often appear on the forehead, cheeks, upper lip, and nose. Epidermal melasma is caused by the overproduction of melanin by the melanocytes in the epidermis.
Causes of epidermal melasma can include hormonal changes, sun exposure, genetics, and certain medications. It is often seen in women during pregnancy or while taking oral contraceptives. People with darker skin tones are also more prone to developing epidermal melasma.
Symptoms of epidermal melasma include brown or grayish-brown patches on the face that have a well-defined border. The patches may also have a slightly raised or rough texture. The pigmentation may worsen with sun exposure and can be more noticeable during the summer months.
Diagnosis of epidermal melasma can be done through a visual examination by a dermatologist or other healthcare provider. They may also use a Wood’s lamp or perform a skin biopsy to confirm the diagnosis.
Treatment options for epidermal melasma can include topical medications such as hydroquinone, tretinoin, and corticosteroids. In some cases, chemical peels, microdermabrasion, or laser therapy may be recommended. It is important to note that treatment for epidermal melasma may take time and require consistent use of medication and sun protection to see results.
Epidermal melasma is a common condition that can be effectively treated with a combination of medication, sun protection, and cosmetic procedures. It is important to consult with a healthcare provider or dermatologist for proper diagnosis and treatment.
Differences between Dermal and Epidermal Melasma
There are several differences between dermal and epidermal melasma:
- Location: The primary difference between dermal and epidermal melasma is the location of the pigmentation. Epidermal melasma affects the outermost layer of the skin, the epidermis, while dermal melasma affects the deeper layers of the skin, the dermis.
- Appearance: The pigmentation in epidermal melasma is well-defined, with a clear border between the affected and unaffected areas of the skin. In contrast, the pigmentation in dermal melasma is less defined, with a more diffuse border and a bluish-grey appearance.
- Response to treatment: Epidermal melasma responds more readily to treatment than dermal melasma. This is because the pigment is located closer to the surface of the skin in epidermal melasma, making it more accessible to topical treatments. Dermal melasma, on the other hand, is located deeper in the skin, making it more difficult to treat.
- Causes: While the causes of both types of melasma are similar, with hormonal changes, sun exposure, genetics, and certain medications being common factors, there are some differences. Dermal melasma is more commonly associated with hormonal changes, while epidermal melasma is more commonly associated with sun exposure.
Dermal and epidermal melasma are two different types of melasma that differ in their location, appearance, response to treatment, and causes. It is important to consult with a healthcare provider or dermatologist for proper diagnosis and treatment.
Conclusion
Melasma is a common skin condition that affects many people, particularly women and those with darker skin tones. There are two primary types of melasma: dermal and epidermal. Dermal melasma affects the deeper layers of the skin, while epidermal melasma affects the outermost layer of the skin.
They differ in appearance, response to treatment, and causes. While treatment for both types of melasma can be effective, it requires a consistent and long-term approach. Consultation with a healthcare provider or dermatologist is important for proper diagnosis and treatment. Sun protection is also critical for preventing melasma and minimizing its progression.
References Website
- American Academy of Dermatology Association. Melasma. https://www.aad.org/public/diseases/color-problems/melasma
- DermNet NZ. Melasma. https://dermnetnz.org/topics/melasma/
- Hsu CY, Yang JY, Kang HY. Management of Melasma. J Clin Med. 2016;5(9):98. doi:10.3390/jcm5090098
- Ortonne JP, Arellano I, Berneburg M, Cestari T, Chan H, Grimes P, Hexsel D, Im S, Lim J, Lui H, Pandya A, Picardo M. A global survey of the role of ultraviolet radiation and hormonal influences in the development of melasma. J Eur Acad Dermatol Venereol. 2009;23(11):1254-62. doi: 10.1111/j.1468-3083.2009.03358.x.
- Rodriguez DA, Berson DS. Melasma and Postinflammatory Hyperpigmentation: Management Update and Expert Opinion. Skin Therapy Lett. 2020;25(1):1-6. PMID: 31905299.
