What Is Melasma and How to Treat It

Melasma is a frustrating and emotionally draining skin condition for as many as five million Americans. If you’re one of them, you know how stressful it can be to manage something that is still so little understood, particularly when symptoms tend to flare up most due to environmental or hormonal factors, both of which you have little control over. Sure, melasma may fade over time, but it’s difficult to give up control in hopes that the condition will resolve itself—particularly if inaction may cause its appearance to worsen.

For those interested in taking control over their melasma, this guide offers an overview to help you better understand the condition, its causes, and how you can reduce its appearance while preventing further skin damage.

What Is Melasma?

Melasma is a form of hyperpigmentation, which is a condition that causes skin to appear darkened or discolored, and is often an umbrella term that covers acne scarring, sun damage, and eczema as well. Melasma is linked to heat, sun exposure, and hormonal fluctuations, and presents mostly on the face. Current statistics report that more than five million Americans have melasma, of which just 10% are men, according to the American Academy of Dermatology. Melasma most commonly affects those with Fitzpatrick skin types III to VI, or medium, olive, and darker skin tones as a result of a greater concentration of melanocytes (melanin) in the skin, which is what forms the hyperpigmentation spots.

Melasma Symptoms

Technically, melasma presents no physical symptoms (side effects that are felt) but rather physical signs (side effects that are seen). For the most part, melasma presents as brown or darker-toned patches on the face, primarily on the cheeks, nose, forehead, chin, and upper lip. These patches may infrequently appear elsewhere on the body, like the neck and forearms, particularly during the summer months when fewer layers mean more skin is exposed to the sun. Different from brown spots which appear as dots, melasma appears as larger splotches in concentrated areas. When magnified, skin affected by melasma often shows signs similar to photodamaged skin, with a thicker, rougher texture.

Common Causes of Melasma

Due to its link to hormones, the use of hormonal therapies, oral contraceptives, hormonal IUDs, and pregnancy may increase your risk of developing melasma. However, with this link not being wholly understood at this time, melasma and hormonal fluctuations are simply correlated rather than hormone levels being a definitive cause of melasma. In other words, those who experience hormone fluctuations may be at higher risk of developing melasma, but could also never develop the condition.

Another common cause of melasma may be excessive cumulative sun exposure. Drugs such as antibiotics, skin care products containing alpha-hydroxy acids (AHAs), or acne treatments like Accutane tend to increase skin’s photosensitivity that can lead to melasma without the proper precautions. Excessive time spent in the sun or tanning beds may also cause melasma.

Melasma could also have a genetic link, which has been more recently supported by studies on various ethnic populations in which melasma is generally more prevalent. It appears that melasma runs in families and the risk of developing the skin condition exists regardless of whether it’s a male or female who inherits the melasma gene. With one study reporting that 70% of Latino men with melasma had a family member who also had the skin condition, it’s clear a genetic component exists.

How to Treat or Prevent Melasma

Because of its link to hormone levels and photosensitivity, melasma can be difficult to treat. Standard melasma treatments work to manage or prevent the worsening of its appearance, particularly during the summer months when heat and increased UV exposure accelerates the development of melasma-related hyperpigmentation. The following are some of the top steps you can take to easily manage the appearance of your melasma:

• Limit sun exposure: How much sun is too much sun? Basically any sun is too much sun for those who have melasma. While spending time outdoors can boost your mood, getting sunlight carries risks alongside those benefits. For this reason, it’s best to limit sun exposure and get additional vitamin D from food sources or supplements.
• Always wear sunscreen: Consider sunscreen a necessity, particularly for any skin that may not be covered by your clothing. Opt for a minimum of SPF 30, reapplied at least every two hours or sooner if you happen to be sweating a lot, and worn regardless of whether it’s cloudy, you’re indoors near a window, or out on the beach.
• Switch up your makeup: Gain an extra level of protection alongside sunscreen with makeup that contains iron oxide. Similar to sunscreen, these products utilize iron oxide to block out visible light and can be layered with your usual SPF for maximum effect.
• Consider hydroquinone or other topicals: A medicine commonly used to treat melasma, hydroquinone may be applied to the affected areas, working to gradually lighten the melasma patches and even out skin tone. Hydroquinone and similar topicals may be purchased in cream, gel, liquid, or lotion form. If over-the-counter topicals don’t appear to work for your skin, talk to a dermatologist about options containing higher concentrations.
• Try laser skin resurfacing treatments: Powered by advanced radio frequency technology, customized skin resurfacing treatments can help target photodamaged skin and uneven skin texture for a smoother, more even-toned appearance. These treatments are safe for all skin tones and at just 15 to 30 minutes per session, they’ll easily fit into your busy schedule.

The one caveat to remember regarding any treatment protocol is that there is no one-size-fits-all approach to skin care. There are many factors that determine how your skin will react to any melasma treatment. For this reason, a combination of preventative measures, quality skin care, and custom energy-based treatments is the best approach to keeping melasma under control.

The first step to discovering the right combination of treatments for your skin is to talk to a dermatologist or certified treatment professional. For those interested in learning more about how radio frequency skin resurfacing treatment plans can help minimize and manage the appearance of melasma, contact a certified provider near you using the search field below.