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What is Melasma and How Can I Treat It?

August 05, 2020 | Anshul Kaushik

What is Melasma and How Can I Treat It?

The term ‘hyperpigmentation’ encompasses a myriad of skin discolorations caused by sun damage, scarring, hormonal changes, inflammation, and more. Pretty much any discoloration or darkening of the skin can be classified as hyperpigmentation. Melasma falls under that classification, and if you’ve never heard of it before, you’re not alone. Many skincare brands and beauty blogs commonly refer to it as “dark spots on the face” or some variation of that phrase, and for the most part, that’s all it is. There aren’t any health concerns surrounding melasma, but it may cause you to be self-conscious or feel the need to break out the heavy-duty concealer before leaving the house.

Melasma mostly appears on the forehead, chin, cheeks, and above the lip. But in less common cases, it can appear on other parts of the body. It’s estimated that over six million Americans are affected by melasma, most of whom are women.

You're more likely prone to melasma if you have a darker skin type. According to the American Academy of Dermatology, this is because darker skin tones naturally have more pigment-producing cells. When these cells become hyperactive and produce too much pigment in certain areas of the skin, melasma forms.

Let’s dive into learning what causes melasma, how to spot if you have it, and how to treat the affected areas.

What Causes Melasma?

There are two main causes of melasma: hormonal changes and sun exposure. Less commonly, melasma also affects men. It may have a genetic component, as it often runs in families.

Hormones

Hormonal fluctuations typically occur in one of two ways, or both: during pregnancy, starting or switching oral contraception (such as birth control pills), or taking hormone replacing therapy. All of these cause inevitably hormonal changes, as they are meant to, and lead to darkened areas on the skin.

Sun exposure

Sun exposure is a major culprit that triggers melasma. Dr. Shadi Kourosh, director of the Pigmentary Disorder and Multi-Ethnic Skin Clinic at Harvard-affiliated Massachusetts General Hospital, says, “Underlying factors such as hormonal changes may not manifest until a person goes on vacation to a southern location like Florida, or during the summertime when she spends more time in the sun. The sun is the major exacerbating factor, whatever the underlying cause.”

Melasma can be caused or brought out by both the sun’s UV rays and heat and visible light. This makes melasma a bit difficult to prevent as even the most powerful sunscreen can’t protect against heat or visible light. Using makeup or other skincare products that contain iron oxide can help block visible light. Avoiding infrared heat can present more of a challenge as it can be generated just by being in hot environments such as a sauna, a steamy kitchen, or even the gym.

How Do I Know if I Have It?

Melasma has its very own pattern of appearance which sets it apart from other hyperpigmentations such as acne scarring or inflammation caused by eczema. If you notice symmetrical, blotchy patches of hyperpigmentation on your cheeks, the bridge of your nose, forehead, chin, or upper lip, it’s likely that melasma is the culprit.

Although it’s less common for melasma to appear elsewhere, the same symptoms can form on the neck or forearms or in other places that are frequently exposed to the sun.

How Can I Treat My Melasma?

Most treatments for melasma are similar, but it’s more complicated to get rid of since it can respond to a variety of treatments, but its response varies from case to case. The following treatments and tips can significantly reduce the appearance of melasma.

Stay away from the sun!

No, you don’t have to stay indoors for the rest of your life, but the first step in treating melasma is to avoid the main cause in triggering the condition. The most important way you can prevent and treat melasma is to follow a strict sunscreen regimen.

Since not all sunscreens are created equal, you’ll need to look for a sunscreen that blocks the sun’s rays as well as light and heat. There are two main types of sunscreens:

  • Chemical sunscreens which use ingredients such as oxybenzone
  • Physical sunscreens that use as zinc and titanium dioxide as blockers

The best sunscreen for those affected by melasma is a non-chemical, blocking sunscreen. This type of sunscreen will block all the light and various wavelengths produced by the sun. Chemical sunscreens will not give your skin the protection it needs and can even trigger allergic reactions that exacerbate the condition.

The summer months are when your melasma will be most triggered, but it’s best to use sunscreen in both the fall and winter months if you’re going to be outside for long periods of time.

Your dermatologist can prescribe treatment

Topicals such as topical retinol and retinoid treatments will help your skin amp up its natural cell turnover process, which, in turn, will help dark patches fade more quickly than they would on their own.

Bleaching agents, such as hydroquinone, will help by blocking melanin production in the affected areas and should only be applied to the darkened spots. This type of product can be purchased over the counter but should only ever been used under a dermatologist’s care. If used incorrectly, products with hydroquinone can cause white spots to develop on the skin. In some cases, it may even cause a darkening of the skin.

Other lightening agents include kojic acid or azelaic acid. Kojic acid blocks tyrosinase, in turn, inhibiting the production of excess pigment and fading melasma. Azelaic acid has been shown to have a similar result to hydroquinone without the negative side effects.

You can try some at-home treatments

If seeking direct help from a dermatologist is out of the equation, there are several at-home treatments dermatologists recommend. The first step, of course, is to reduce sun exposure. You can also develop a skincare routine to help fade and hopefully clear up your melasma.

Be sure to wash your face every morning and night, which, to be honest, you should already be doing anyway. Environmental pollution can contribute to melasma as airborne pollutants bind to your skin and damage its natural barrier. A weaker skin barrier makes you more susceptible to sun damage. Find a gentle but effective cleanser, and wash your face every morning and before bed.

Incorporating antioxidants into your skincare routine can help heal the damage and stress caused by sun damage. Look for serums containing vitamins C and E, which are most effective when paired together.

Follow with a moisturizer to help restore your skin’s lipid barrier. Doing so keeps your skin stronger and more likely to stay protected from damage.  A sunscreen-moisturizer combination is good for daily use as it is lightweight and will not leave any significant visible residue behind even on darker skin tones. For night time, a moisturizer containing ceramides or hyaluronic acid can help boost your skin’s barrier by locking moisture in.

Above all, you need to be patient and diligent. Melasma will not clear up overnight, and it may take several months for you to see significant changes. Make sure you commit to a routine, as melasma can pop back up pretty quickly if you aren’t careful about sun protection.

While there are no known health risks associated with melasma, it’s understandable to want to clear it up as best as you can. Everyone should feel comfortable in their own skin, and as long as you are careful and stick to the right skincare routine, you may just achieve the results you want.

Have you found any of the above recommendations work better than others? We want to know what has helped you achieve results! Let us know your melasma tips and tricks and help others on their journey by leaving a comment below.