Melasma on the Neck?

Question

I am a 50-year-old fair-skinned female and over the last three years I've developed light brown discoloration on the sides of my neck. I've never had any type of brown discoloration on my face other than freckles. I do have rosacea which was successfully treated with IPL. Is it possible to develop melasma for the first time in the mid-forties and to develop it only on the neck?

Jason Emer, MD · Answer

Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + Brilliant, peels, microneedling/PRP, Aerolase, and sometimes Erbium (Cool Laser) to get the best results. See an expert for a formal evaluation. Best, Dr. Emer

Anil R. Shah, MD · Answer

Hello, melasma can be treated using the following:
-Pico lasers- The best type of laser for improving the condition.  Please note it takes multiple steps to improve melasma safely
-Nd:YAG Nano lasers with toning- Here a laser is used for deeply resistant melasma to break up particles without generating excessive heat
-Melanage peels- A variety of peels can work and melanage is one of the best for melasma
-Skin topicals- A variety of products including use of lighteners (we prefer natural lighteners such as arubtase found in our product Luminoso) as well as sunscreens can help improve the condition
-Lifestyle choices-Avoiding the sun, hormonal changes (we have a hormone expert in Dr. Chughtai in our office) can all impact melasma.
While melasma is common, patients must understand a multi pronged approach is often the best strategy and controlling this condition.
Best, 
Anil Shah MD

Raffy Karamanoukian, MD, FACS · Answer

Neck and mandibular melasma is quite common. There may be associated poikiloderma. I would begin with Melarase AM, Melarase PM, Melapads, and Replenish cream prior to any laser or IPL therapy.Best, Dr. KaramanoukianLos Angeles

Hratch Karamanoukian, MD, FACS · Answer

Melasma can occur on the neck or more generalized hyperpigmentation from irritation and neck moisture. Daily good habits with topicals may well help you chieve your goals with a good skin system like the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 
Melarase AM is non hydroquinone based and allowed for use in the EU and UK.
Best

H Karamanoukian MD FACS

Alex Eshaghian, MD, PhD · Answer

Thank you for your question BrTsr. Melasma is a common condition characterized by the appearance of dark patches on the skin. Commonly affected areas include the forehead, cheeks, and upper lip, as these areas have high levels of sun exposure. The neck is an uncommon area to be affected with melasma. Poikiloderma if Civatte and acanthosis nigricans are more common on the neck. Please consult with a doctor for specific recommendations. Good luck!

Melasma on the Neck?

Answers (6)