What is Melasma: Causes, Treatment, and Prevention

Have you noticed patches of skin discoloration on your face? You may be dealing with melasma, a common skin condition.

What is Melasma?

Melasma is a skin condition characterized by patches of brown, tan, and blue-gray skin discoloration, and it’s most often seen in women in the middle of their reproductive years. Melasma is a form of facial pigmentation, and it’s typically found in three different areas of the face: the jawline, the central part of the face, and the cheekbones. Many people will notice melasma on the bridge of their nose, chin, and forehead, but it may appear on other areas of the body, including the neck, chest, or arms—any patch of skin that sees the sun a lot.

Melasma doesn’t have any lasting health consequences; however, these patches can cause distress and embarrassment. The good news? There are plenty of ways to reduce the appearance of this skin condition. Let’s delve into the causes of melasma and consider the ways you can treat and prevent future discoloration.

What Causes melasma?

Experts have yet to pinpoint the exact cause of melasma. Researchers believe that the dark patches may occur when the skin’s color-making cells (melanocytes) create too much color. That’s why people with skin of color are more likely to experience melasma; they have more active melanocytes than those with fair skin.

The appearance and severity of melasma can be triggered by three main factors: hormonal fluctuations, sun exposure, and genetics.

Let’s take an in-depth look at two of these melasma causes.

• Hormonal Fluctuations: Any shift in hormones can trigger melasma. Pregnant women experience significant hormonal fluctuations, and melasma is so common during the gestational period that it’s become known as the “Mask of Pregnancy.” Birth control and hormonal replacement medication can also contribute to hyperpigmentation.
• Sun Exposure: Ultraviolet rays can stimulate the melanocytes in your skin, and sun exposure can make melasma worse. That’s why melasma tends to be worse in the summer, and faded hyperpigmentation may return when you spend too much time in the sun.

Is Melasma Common?

Yes! Melasma is one of the most common skin conditions in the United States. Melasma is more common in women than men, and often shows up during pregnancy. Typically, melasma shows up between the ages of 20 and 40, but there are cases of childhood melasma that continue well into adulthood.

Those with tan or naturally brown skin are more likely to experience melasma than those with fair or black skin, and people who live in areas that see intense bouts of ultraviolet rays may have more severe melasma discoloration.

How Do I Know if I Have Melasma?

This skin condition can be diagnosed by simply looking at it; dermatologists will often visually examine the skin. They may use a special tool called a Wood’s light to help assist in this diagnosis, which helps them determine how deep the melasma has penetrated your skin. Generally, the characteristics of melasma can be seen with the naked eye.

If your physician is concerned the discoloration may be caused by another disease or condition, they may elect to take a skin biopsy, but this is very rare.

Are There Different Types of Melasma?

Yes. There are three types of melasma diagnoses: epidermal, dermal, and mixed.

• Epidermal: This type is characterized by dark brown patches with a well-defined border. This type of melasma typically responds very well to treatment, and is more readily apparent under black light.
• Dermal: This type is characterized by light brown or bluish patches with a less-defined border. This type doesn’t respond very well to treatment, and its appearance doesn’t changed under a black light.
• Mixed: This is the most common type of melasma diagnosed, and is characterized by a combination of light and dark brown patches and bluish discoloration. This type is relatively responsive to treatment.

Myths about Melasma

There are some pervasive myths about melasma that are simply untrue. These include:

• Only pregnant women get melasma: melasma can affect men and women of all ages, in all stages of life.
• Melasma goes away on its own: Unfortunately, you’ll need to treat your melasma with care—it doesn’t tend to go away of its own accord.
• You can’t reduce the appearance of melasma: There are plenty of treatment options that can help reduce melasma patches.

How Do I Treat Melasma?

If you already have skin discoloration as a result of melasma, there are a few ways to go about managing it. While some hyperpigmentation may be permanent, certain treatment options can greatly reduce the appearance discoloration.

At-Home Melasma Treatment and Prevention

You can take the reins of your melasma treatment at home. Managing this skin condition means understanding your triggers and doing all that you can to avoid them. If you are struggling with melasma, make sure you practice the following to help create a more even skin tone.

• Wear sunscreen every day: One of the best ways to treat and prevent melasma is with proper sun protection. Because sun exposure triggers this skin condition, you must wear sunscreen every day, whether it’s sunny or overcast. Always opt for sunscreens with broad-spectrum protection, and be sure to reapply at least every two hours. If you plan to go swimming or do an activity that causes heavy sweating, reapply sunscreen more frequently.
• Wear protective clothing: Sunscreen is priority number one, but you can increase your sun protection by adding a wide-brimmed hat, baseball cap, and layered clothing to your wardrobe.
• Don Some Shades: Throw on a pair of sunglasses to shield the sensitive skin around your eyes, but make sure you’ve selected the right style. Avoid sunglasses metal rims; these can attract heat, and when placed against your skin, make melasma worse.
• Don’t wax: Try not to wax, as this can cause immediate skin inflammation that can make melasma worse.

Dermatologist Treatment Options

For some, melasma only sticks around for a few months or years, but others can struggle with this skin condition for decades. In these cases, professional treatment may be the best solution. Professional dermatologists can tackle your melasma in a few different ways:

• Hydroquinone: This is the most common treatment option for melasma. Applying Hydroquinone to the skin lightens it, and you can get this medicine in cream, lotion, gel, or liquid form. Some of these options are available without a prescription, but these are generally less strong (read: less effective) than the options your dermatologist would prescribe.
• Tretinoin: To enhance and expedite the effects of hydroquinone, your dermatologist may prescribe Tretinoin.
• Corticosteroid: Many health professionals promote prescription products that contain three ingredients: the previously mentioned hydroquinone, retinoid, and corticosteroid. The retinoid helps speed up skin cell turnover, while the corticosteroid helps reduce inflammation. According to one study out of Sty Luke’s Roosevelt Hospital, almost 70 percent of patients see around 75 percent improvement in their melasma after only two months of using this type of product.
• Chemical Peels: Light chemical peels use salicylic acid, glycolic, or other chemical components to remove the top layers of skin from the face for a more even skin tone. After this procedure, your skin will be pink and sensitive—many say it feels almost like a mild sunburn. After a few days, the skin will begin to peel. Light skin peels can be done every two months.
• Microdermabrasion: Regular treatments of microdermabrasion may help reduce the appearance of melasma, as this procedure helps increase cell turnover, helping get rid of cells already affected by the hyperpigmentation. Don’t ever try this kind of procedure without the help of an experienced professional.
• Laser Treatment: Many lasers can make melasma worse, but there are certain systems that can help reduce the appearance of this skin condition. This can be an expensive procedure, and the jury’s still out on how effective this treatment method really is.

Melasma and Pregnancy

Many women deal with melasma during pregnancy (you’ll often hear of it referred to as Chloasma) According to the American Congress of Obstetricians and Gynecologists, almost 70 percent of pregnant women develop this skin condition.

Don’t worry about this skin condition affecting your little one—it’s harmless. If it shows up during pregnancy, it’s likely that it will resolve after the baby has been delivered. It may come back with recurrent pregnancies though, and can be worse if you’re pregnant during the summer season.

Quick Facts About Melasma:

• Melasma is common in women 20 to 50 years old
• Melasma often arises during pregnancy
• Melasma is found on three areas: the cheekbones, jawline, and central face
• Dermatologists can prescribe lightening agents or perform in-office procedures to treat melasma
• The best way to manage melasma is by using proper sun protection.

If you’ve noticed discoloration on your face, melasma could be the culprit. This common skin condition can’t be completely eradicated, but the right management strategies and products can help you achieve an even skin tone and get the radiant complexion you deserve.