Melasma is a common skin condition that causes brown and grey-brown patches to form on the patient’s face. Also known as “the mask of pregnancy,” the exact causes of melasma are not fully understood, but sun exposure, hormonal fluctuations, pregnancy, birth control medications, some other medications and the use of harsh cosmetics play a role.
What is Melasma?
Melasma is a common condition where the color-making cells in the skin, melanocytes, produce too much color, creating patches of darker skin. Although it can develop on other areas of the body that receive a lot of sun exposure, most patients get melasma on their cheeks, nose, forehead, chin, and above the upper lip.
Women are far more likely to develop melasma than men. It is also relatively more common an darker skin people. Another term, chloasma, is sometimes used to describe melasma that occurs during pregnancy.
Although a direct cause of melasma is unclear, there are some common triggers:
- Sun exposure — Ultraviolet (UV) light from sun exposure stimulates the melanocytes. This is the skin’s protection mechanism against sun damage, darkening the skin. People who get melasma usually have reoccurrences during the summer months.
- Hormonal activity — There is a relationship between hormonal changes and melasma. Pregnant women often get melasma, and their wildly fluctuating hormone levels are thought to be the trigger. In fact, one half of all melasma cases develop initially during pregnancy. Also, women on birth control pills and hormone replacement therapy patients are prone to the condition.
- Skin care products — If a skin care product or cosmetic irritates your skin, melasma can return or worsen.
How is Melasma Diagnosed?
As you would expect, most cases of melasma can be diagnosed simply by visually checking the patient’s skin. To get an idea of how deeply the condition penetrates the skin, Dr. Khatri may use a special light. If uncertain your condition is indeed melasma, a tiny skin sample can confirm it.
This is a combination of laser resurfacing and chemical bleaching agents. It does not need injection anesthesia and can be done with anesthetic creams and is relatively painless and has very little downtime. Melasma can fade, as mentioned above, when issues such as hormone fluctuations level off. But if a woman needs to stay on the pill, or if her melasma simply keeps returning, Dr. Khatri has various treatment options.
- Hydroquinone — This medicine lightens the skin; it is often the first treatment option. Dr. Khatri can prescribe more effective hydroquinone than is available over the counter.
- Tretinoin and corticosteroids — These options can enhance skin lightening. There may even be an option of prescribing a single medicine with hydroquinone, tretinoin, and a corticosteroid.
- Other skin lightening creams – there are other non-hydroquinone based creams that can also be used safely to lighten melasma
- Laser resurfacing — Laser resurfacing can effectively remove areas of persistent melasma.
- Chemical peels — Chemical peels remove the top layer of the epidermis and can be effective for lightening areas with melasma.
Dr. Khatri has good success helping patients with persistent melasma. Treatment may take a few months, however, so patients shouldn’t expect immediate results. Also, once your melasma clears, we will recommend maintenance therapy to keep it from returning.
Who’s Likely to Develop Melasma?
Women are far more likely to develop melasma; just 10 percent of cases occur in males. People with darker skin tones are more likely to develop melasma because they already have more active melanocytes in their skin. Also, people with family history of melasma are much more likely to get melasma themselves.
What can I do to prevent melasma?
There are tips you can follow to help prevent melasma from developing or reoccurring, especially if you have darker skin tones:
- Wear sunscreen — Sun exposure triggers melasma, so wearing sunscreen with at least an SPF of 30 is recommended at all times. Your sunscreen needs to protect against both UV-A and UV-B rays.
- Wear wide-brimmed hats and sunglasses — Some studies show that even with sunscreen on, some people still develop melasma. It’s thought that longer UV wavelengths may be to blame. So, if you’re prone to developing melasma, protective clothing and sunglasses are a must.
- Opt for gentle cosmetics and skin care products — If you’re using products that tend to sting or burn when applied, they can worsen melasma.
- Avoid waxing — Waxing areas such as above the upper lip can cause skin inflammation that worsens melasma.
- Hormones – Use birth control method that would not cause or worsen Melasma, such as a condom.
Does Pregnancy Mask Go Away?
Some pregnancy masks are persistent, Dr. Khatri is offering this new treatment to patients who have resistant “Melasma/Pregnancy Mask”.
Tips To Prevent Melasma During Pregnancy
In addition to sunscreen and protective sun clothing, be extra cognizant of the lotions, cosmetics, and cleansers you use during pregnancy. For instance, shower gels with natural extracts are a better choice than more harsh formulations. Avoid soaps and gels with strong perfumes, as well. Avoiding sun exposure is a natural way to temper any melasma.
Will my melasma continue after pregnancy?
For most people, once their hormones return to normal levels after childbirth their melasma resolves itself. However, in cases noted above — patients with darker skin tones, patients returning to birth control pills, patients with a genetic tendency — melasma can return. This makes sun protection very important.