What is melasma, and what are some melasma treatment options that could work for you? If you have dark patches on your skin that are brown or blue-gray in colour, and seem to get darker with sun exposure, you could have melasma. For most people, the skin condition of melasma is far more concerning than age spots, because melasma spots are larger, more noticeable and more difficult to get rid of.
Sometimes, melasma is also called a “mask for pregnancy” because it frequently appears in pregnant women due to hormonal changes. Thankfully, in this instance, it will naturally fade away on its own after birth.
Another term for melasma is chloasma, but it is a less common name. Even though this skin condition is completely harmless and painless, it can cause self-esteem issues. It’s understandable why melasma makes people self-conscious since the dark spots frequently appear on the face. Sometimes, dark melasma spots on a woman’s upper lip, for example, can cause the illusion of a moustache. This is one of many reasons why melasma treatment is sought out by those with this skin condition. Learn more about melasma below:
What Exactly is Melasma?
Melasma is a common skin condition that results in dark and discoloured patches on the skin. This is because the skin overproduces the cells called melanin which make the colour of your skin. Though melasma is harmless, it can be very annoying, especially if you get many spots in different areas.
Melasma is more prevalent in women, though men can get it as well. According to studies, 90% of the people who acquire melasma are females. This condition commonly happens during a woman’s reproductive years, around 20 to 40 years of age. It rarely manifests at the stage of puberty.
Pregnant women who have melasma experience it during the duration of their pregnancy. However, those who develop chronic melasma may have this skin condition their entire lives. Thankfully, the discoloured patches are not painful, itchy, or uncomfortable in any way. They are also not cancerous or precancerous.
However, this skin condition can impact self-confidence, especially when you have large, dark spots on your face. Fortunately, you can seek help from a dermatologist or skin specialist that focuses on treating skin disorders to address skin discolouration.
What Happens to Your Skin with a Melasma Condition?
The human body’s largest organ is the skin, making up about 1/7th of your body’s weight. The skin contains three layers, epidermis, dermis, and subcutaneous layer. They all serve as a barricade to protect bones, organs, and muscles from harsh environmental elements. All the skin layers also help regulate body temperature, prevent dehydration, and help you feel sensations.
Of the three layers, the epidermis or the top layer contains cells known as melanocytes. They store and produce a colour pigment called melanin. Stimulus like UV rays or heat exposure and hormonal changes encourage melanocytes to produce more melanin. And this is why you get dark patches or melasma.
Melasma comes in three forms, and they are differentiated with the depth of the pigment. Your dermatologist can determine the melasma severity using a special black light. The three types of melasma are:
- Epidermal: This variant is dark brown with well-defined borders. It is very obvious under black light. More often, this responds well to treatment. Since it is at the top layer, it is dubbed superficial melasma.
- Dermal: This affects the innermost layer and manifests with light brown or blue-tinged spots with a more spread-out appearance. They have blurry borders and appear no differently under black light. Sadly, this doesn’t respond well to treatment. Another term for this is deep melasma.
- Mixed: As the name suggests, it combines light brown, dark brown, and blue patches. It has a mixed pattern under black light, with some responding to treatment. This is the most common form of melasma.
How Does Melasma Manifest?
The melasma patches are darker than your normal skin colour, and they typically darken and brighten with time. It often gets worse in the summer and a tad lighter in the winter. Most of these patches appear on the face, and you can find symmetrical marks that match on both sides. You can usually spot these patches in the following areas:
- Nose bridge
- Upper lip
Melasma patches can also appear in other areas of the body that are frequently exposed to the sun, like your neck and forearms. Though this skin discolouration doesn’t adversely affect health, it can make you feel self-conscious because it looks very noticeable. If you observe symptoms of melasma, it would be advisable to see a dermatologist.
How is Melasma Diagnosed?
The dermatologist usually conducts a visual exam of the affected area to confirm melasma. Your doctor can also run some blood tests to rule out specific causes like hormonal imbalance. A common testing technique is known as a Wood’s lamp examination using a black light. The doctor uses this special light and holds it up to your skin to perform a closer inspection.
This lamp allows the doctor to assess the severity of your melasma and check how many skin layers are affected. The special light also helps your healthcare professional check for fungal or bacterial infections.
The Various Risk Factors of Melasma
Today, the true cause of melasma is unclear, but experts agree that it is triggered by excess melanocytes, with darker-skinned individuals more at risk than those with lighter skin colour. In addition, estrogen and progesterone sensitivity can trigger melasma, which is why pregnancy, thyroid issues, hormone therapy, and birth control pills can all stimulate the growth of dark patches.
Moreover, the sun can be a catalyst to melasma formation because the UV rays affect melanocytes or the ones controlling the skin’s pigment. This is one of the reasons why melasma looks more dark, deep, and prominent after sun exposure. Tanning beds are also a culprit, along with certain skincare, makeup products, or medications that result in a phototoxic reaction (or making the skin sensitive to light).
On top of that, stress is also a known risk factor that can contribute to the exacerbation of melasma because it affects the hormones in the body. Besides, most skin specialists concur that melasma has a strong genetic component because patients whose close relatives have experienced melasma are highly likely to develop dark patches, too. Notably, 33% to 50% of melasma patients shared that someone in their family had it.
Melasma Treatment Options
There are various melasma treatment options that might work for you. It’s important to note that for some women, melasma disappears on its own. This typically happens when the trigger for melasma was pregnancy, hormone therapy, or medication. As for those with chronic melasma, your derma can prescribe topical steroids like hydrocortisone or certain acids like azelaic acid, tranexamic acid, alpha hydroxy acid to even out skin tone.
Tretinoin or hydroquinone may also be prescribed to gently peel and lighten the affected area (but these treatments are not allowed for pregnant or breastfeeding women). Then, you just need to apply lotion or cream based on your derma’s recommendations.
If those don’t work, you may need dermabrasion, microdermabrasion, chemical peels, laser therapy, or other procedures administered by your dermatologist in the clinic. These treatments are more aggressive and provide a deeper peel to target the dark patches.
However, these procedures may not completely lighten melasma in one go. Therefore, you may need to return for follow-up checks to ensure melasma doesn’t come back. Don’t forget to ask your doctor about the pros and cons of each suggested treatment so you can make an informed choice.
Coping Strategies For Dealing with Melasma
Though some melasma cases will not clear up even with aggressive treatment, there are things you can do to ensure your patches won’t get worse. For starters, you can camouflage discolouration with gentle makeup and concealers. Steer clear of those with harmful additives because they may worsen discolouration.
Most importantly, you need to make lifestyle changes to ensure your melasma doesn’t get any worse. For starters, religiously apply the medication given by your doctor. Taking Vitamin D and Vitamin C supplements may also stop your cells from proliferating, which means they impede the overproduction of melanin.
Most of all, avoid sun exposure, tanning beds, LED screens, and irritating skincare ingredients. You may also need to ask your doctor if shifting your birth control pills will help. Finally, make it a habit to do the following:
- Wear sunscreen daily with a minimum of SPF30 on the face and body
- Reapply sunscreen every 2 hours if you are out in the sun
- Don a wide-brimmed hat to provide shade for your face
- Put on protective clothing, especially if you will be out in the sun for long periods
If you feel self-conscious about melasma, speak with your dermatologist about various treatment options. You can find out if you’re genetically at risk for various skin conditions by taking a DNA test through CircleDNA. DNA test results will reveal your susceptibility to various skin conditions and other health conditions. Your DNA report will also include a skin profile to illustrate your skin type and other skin tendencies. Having the right information can assist you in taking a more proactive approach in mitigating skin conditions such as melasma onset, or preventing its exacerbation.