What you need to know about melasma

Melasma is a common skin problem that many people don’t know about and don’t realize they have. It shows up as brown and grey-brown patches on your cheeks, nose, forehead, chin and above your upper lip, and sometimes on your neck or forearms (think places that get a ton of sun exposure).

Melasma is a visible skin problem rather than an uncomfortable one. And while it doesn’t hurt or irritate you physically, no one likes brown splotches appearing on their face suddenly, out of nowhere!

Who gets it and why?

People with darker skin tones, people who tan easily and those whose family members have melasma are more susceptible. The specific cause of melasma is unknown; however, it’s thought that the melanocytes (cells that cause pigmentation) of people with melasma are overactive. But even though we don’t know the exact cause, we do know melasma’s triggers.

The sun

As with most skin problems, sun damage plays a significant role. In this case, UV rays stimulate melanocytes, which means that even minimal exposure can bring melasma back. That explains why it recurs.

Your hormones

Hormones seem to be the likely culprit, since women tend to get melasma more than men (only 10% of sufferers are men) and it often comes hand in hand with pregnancy. When pregnant women get it, it’s called chloasma (the mask of pregnancy). Birth control pills and hormone replacement therapies can also bring it on.

Your skin care regimen

Combine an irritating skin care product with sun exposure and/or pregnancy and melasma can worsen. That’s a great reason to take good care of your skin with dermatologically approved products for daily advanced skin care, like SkinCeuticals.

How is it diagnosed and treated?

As skilled skin experts, dermatologists can diagnose melasma on sight, but we may examine your skin with a Wood’s lamp to see how deeply it penetrates your skin. Even though we can usually diagnose it immediately, melasma can look like other skin conditions, so we may need to perform a skin biopsy to confirm.

For some people, melasma fades without treatment once a trigger is removed (after pregnancy or going off birth control pills), but that’s not always the case. And even though treatment can eliminate your melasma, it tends to recur, especially if you’re not taking proper care to avoid sun damage and look after your skin.

The best way to tackle melasma is with a combination of medical treatments, sun protection and an advanced daily skin care regimen.

Medical treatments

There are many medical treatments you can try for melasma, and they vary based on your skin and your budget. Be sure to consult an expert dermatologist about melasma treatment, because the wrong treatment can create new skin problems; treatments must be tailored to your specific skin.

Medical procedures. Depending on your skin, we may suggest laser or light-based treatments, or medical facials like a chemical peel or microdermabrasion. Each of these has its own unique benefits and may also help correct other skin problems or concerns.

Medical-grade topical treatments. Hydroquinone comes as a cream, lotion, gel or liquid and works to lighten the skin. You may benefit most from azelaic acid, kojic acid, tretinoin, a corticosteroid or a triple cream (a combination of hydroquinone, tretinoin and a corticosteroid).

Some of these topical treatments are available over the counter, while others need a prescription, but your dermatologist will recommend the best option for you.

Sun protection

The number one treatment for melasma is sun protection. Because the sun is a major trigger, wear a broad-spectrum sunscreen of at least SPF 30 with zinc oxide or titanium dioxide on your face every day (even on cloudy days and even in winter). Give the sunscreen 15 minutes to set before going outside and reapply every couple of hours.

While this is a good treatment for melasma, it’s good practice for your skin no matter what conditions or concerns you have. Also shade your skin as much as possible with hats and clothing for extra protection, since sunscreen alone may not be enough.

An advanced daily skin care regimen

Low-grade skin care products can irritate the skin, causing stinging or burning. A healthy regimen helps prevent skin concerns, treat skin problems and maintain healthy skin. At Rao Dermatology, we use SkinCeuticals because it’s backed by science and continually wins awards for its pharmaceutical-grade products.

While it’s not exactly a treatment, if your skin is sensitive or prone to melasma, try to avoid waxing. Waxing can cause inflammation and aggravate melasma, so ask us about other hair removal options that will work for you.

What can you expect from melasma treatment?

Melasma can be a stubborn condition, but with a dermatologist’s care and a few months of treatment, you should see improvement. To get the most out of your treatment, take particular care to follow your dermatologist’s instructions. After it clears, you may need to continue maintenance therapy to keep the melasma from recurring.