That's because "many patients with melasma have a component of dermal melasma, rather than purely epidermal, meaning that the pigment sits in deeper layers of the skin in addition to superficial ...

As mentioned previously, epidermal and dermal melasma respond very differently to treatment. Coverup with opaque cosmetics remains essentially the only option for dermal melasma. An exception to ...

Here's where things can get a little more complicated though, as there are three different types of melasma. Epidermal is dark brown and defined, dermal is more on the light brown or even blue ...

During this exam, the lamp highlights epidermal melasma, but not dermal melasma. Histologic studies demonstrate increased melanin in either the epidermis (basal and suprabasal layers), dermis ...