What is the Difference Between Dermal and Epidermal Melasma

The key difference between dermal and epidermal melasma is that dermal melasma is caused by the excessive deposit of melanin pigment in the deeper layers of the skin, while epidermal melasma is caused by the excessive deposit of melanin pigment in the superficial layers of the skin.

Melasma is a skin condition in which dark patches appear on the face. It is usually due to the excessive melanin pigment deposition in the skin. These dark patches usually have distinct edges and are symmetrical in nature. When this condition occurs during pregnancy, melasma is often called chloasma or mask of pregnancy. Melasma is a common condition and can occur in up to six million American women. There are two main types of melasma: dermal and epidermal melasma.

CONTENTS

1. Overview and Key Difference
2. What is Dermal Melasma
3. What is Epidermal Melasma
4. Similarities – Dermal and Epidermal Melasma
5. Dermal vs Epidermal Melasma in Tabular Form
6. Summary – Dermal vs Epidermal Melasma

What is Dermal Melasma?

Dermal melasma is a type of melasma caused due to the excessive deposition of melanin pigment in the deeper layers of the skin. It occurs between the inner layers of the skin. This region is found between the epidermis (outer layer of the skin) and subcutaneous layers. The signs of dermal melasma include ill-defined light brown to blue-grey patches on the face. Moreover, in a wood’s lamp, melasma is classified as dermal melasma when there is no enhancement seen. In dermoscopy, melasma is classified as dermal melasma when an irregular pigment network with bluish grey pigmentation is noted.

The treatment of dermal melasma is very difficult when compared to epidermal melasma. Dermal melasma also has a poor response. The treatment may include chemical peels, microdermabrasion, and lasers.

What is Epidermal Melasma?

Epidermal melasma is a type of melasma in which excessive deposition of melanin pigment occurs in the superficial layers of the skin called the epidermis. In epidermal melasma, the melanin pigment is elevated in the suprabasal layers of the epidermis. The signs of epidermal melasma include well-defined dark brown color patches on the face. Moreover, in wood’s lamp, melasma is classified as epidermal melasma when there is enhancement seen. In dermoscopy, melasma is classified as epidermal melasma when a regular pigment network with a brownish homogenous pigmentation is noted.

The treatment of epidermal melasma is pretty easier when compared to dermal melasma. The treatment usually shows a good response. Furthermore, the treatment options may include bleaching agents, a combination of hydroquinone, tretinoin, and moderate potency topical steroids, galvanic or ultrasound facials with a combination of topical cream or gel, chemical peeling, and laser therapy.

What are the Similarities Between Dermal and Epidermal Melasma?

• Dermal and epidermal melasma are two main types of melasma.
• Women are mainly affected by both conditions.
• The face is the place that is commonly affected by both conditions.
• Both conditions are often seen during pregnancy.
• They are treated by applying creams, gels, or technical procedures such as a laser.

What is the Difference Between Dermal and Epidermal Melasma?

Dermal melasma is seen in the deeper layers of the skin, while epidermal melasma is seen in the superficial layers of the skin. Thus, this is the key difference between dermal and epidermal melasma. Furthermore, the signs of dermal melasma include ill-defined light brown to blue-grey patches on the face. On the other hand, the signs of epidermal melasma include well-defined dark brown color patches on the face.

The below infographic presents the differences between dermal and epidermal melasma in tabular form for side-by-side comparison.

Summary – Dermal vs Epidermal Melasma

Melasma is a common skin condition characterized by brown or blue-gray patches or freckle-like spots on the face. It is commonly seen in women during pregnancy. Melasma happens due to the overproduction of melanin. Dermal and epidermal melasma are two main types of melasma. Dermal melasma occurs in the deeper layers of the skin while epidermal melasma occurs in the superficial layers of the skin. So, this is the difference between dermal and epidermal melasma.

Reference:

1. “Melasma.” UptownDerm, 13 Aug. 2017.
2. “Melasma.” DermNet NZ.

Image Courtesy:

1. “SOX10 immunohistochemistry of normal skin and atypical melanocytic proliferation” By Mikael Häggström, M.D. – Own work (CC0) via Commons Wikimedia
2. “Hiperpigmentacija na licu” By Ok.online – Own work (CC BY-SA 4.0) via Commons Wikimedia