Melasma is a very common condition that causes dark discoloration of the skin. It frequently occurs on the cheeks, bridge of the nose, forehead, chin, and upper lip of women, but it can also occur in men. It may also appear on other parts of the body that receive frequent sun exposure such as the shoulders, upper arms and chest. Melasma is not itchy, painful, or raised.
Causes of Melasma
Sun exposure plays a major role in the development of melasma. Ultraviolet light (UV) stimulates the skin’s melanocytes which causes darker pigmentation. A small amount of sun exposure can make melasma return after fading. Melasma often worsens in the summer due to increased sun exposure.
- Visible light, such as light in a room or a computer screen can contribute to melasma.
- Other UV sources such as light from sunroofs, window light in offices, car-side windows, or sunroofs.
- Heat can also cause melasma, such as that caused by cooking and heat in areas with a warm climate. Wearing metal-rimmed sunglasses absorbs more heat and can worsen melasma. Frequent exposure to heating lamps, hair dryers, or lamps used to treat season affective disorder can be triggers.
- Hormonal changes, such as those caused by pregnancy, birth control pills, hormone-releasing intrauterine devices (IUDs), hormone replacement therapy, nursing, or extensive amounts of soy intake can also contribute to the development of melasma. Autoimmune thyroid disorders, chronic stress or adrenal dysfunction also trigger the melanocyte stimulating hormone (MSH).
- Phototoxic reactions caused by scented or deodorant soaps, toiletries, cosmetics, and fragrances.
Treatment of Melasma
Melasma is never cured; however, it can be maintained. Treatments to fade melasma include the use of:
- Skin lightening/bleaching creams containing hydroquinone
- Skin lightening pads
- Chemical peels
- Fractional Laser Treatments
Prevention and Maintenance of Melasma
Melasma often improves with treatments; however, it may take a few months before you see improvements. Melasma may recur.
- Sun protection is the most effective way to prevent melasma. Sunscreen with SPF 60 or more every day is recommended. We also recommend use of a wide-brimmed hat when exposed to the sun. Sunscreen should block UVA/UVB rays and visible light. Look for sunscreens containing iron oxide, which blocks visible light.
- Discontinuing medications that affect hormones is the only way to prevent melasma from worsening if your melasma is triggered by hormonal changes.
- Antihistamines can reduce melasma, as it has been found that increased mast cells, immune cells that cause allergies in the skin, have been associated with melasma.
- Coffee, blueberries, and red wine contain antioxidants that have been found to help control melasma.
- Niacinamide supplements have also been found to help with melasma because they inhibit melanocytic transfer (the transfer of pigment to the skin).