Melasma – Dermatologist Explains What You Need to Know

Why Do People Usually Get Melasma?

We don’t entirely understand why some people get melasma. We do know that light causes pigment to form and that cells in the skin hang onto the pigment abnormally. Areas of skin with melasma also show sun damage, excess circulation of blood vessels and unusual, immune reactivity.

Genetics also play a role.

The bottom line is that we see pieces of the mystery surrounding melasma, but we don’t know how the process works that leads to it.

How often do I see melasma in my practice?

Melasma is common. Almost 9% of women have melasma. While most people with melasma are women, men can get it, too.

Why are women more likely to develop melasma during pregnancy and with birth control pills?

Hormones can make melasma worse. The problem is complicated though because it is not just the hormone level that’s the problem. It is more a problem with the hormone receptors in the skin. That means that when the hormones are coming from birth control pills, for example, you can’t just lower the dose and control the melasma. You need to stop the pills entirely to reduce the risk of melasma. In pregnancy, there is nothing you can do about your body’s particular hormone levels and how they react with the receptors.

Why are women more likely than men to get melasma?

We don’t know, but we know that hormones in birth control pills and pregnancy make melasma worse so the hormone characteristics in female physiology undoubtedly play a role. According to the American Academy of Dermatology, 90% of melasma cases are seen in women. 

What types of skin care can make melasma worse?

Why do people get melasma? Here's help.It is really laser and light procedures that are unpredictable and can make melasma worse. Skin care usually is not a driver of melasma, and in fact, we usually treat melasma with a multi-step skin care routine designed to reduce pigment production, enhance ingredient penetration into skin, fight inflammation that may play a role in melasma, and block sun from hitting skin cells to turn on pigment production.

I created my Pigment and Sun Damage Repair Kit to cover all of these aspects of melasma skin care.  

What skin conditions can mimic melasma?

Conditions that can be confused with melasma include:

  • post inflammatory hyperpigmentation (brown marks left behind by skin injury such as acne);
  • solar lentigines (sun spots);
  • poikiloderma of Civatte (hyperpigmentation on the sides of the neck from sun damage);
  • drug-induced hyperpigmentation (a specific reaction between your skin, a medicine and sun exposure); and
  • lichen planus pigmentosis (a rash with gray/brown color and a diagnosis that requires evaluation by a dermatologist).

When should you see a doctor for melasma?

You should see a doctor if melamsa is causing you stress and emotional destress – as it can and often does! Also, if the hyperpigmentation of melasma is worsening, you should ask for help early-on because it is easier to prevent worsening than it is to reverse it. If you skin care routine is not preventing melasma, see a doctor, again. Prevention works the best and is best started early.

What can people expect the outcome to be after starting treatment for melasma?
Can you fully get rid of melasma? Or, will treatment just lighten it but not get rid of it entirely?

Melasma is worse during the child-bearing years for women. Yes, your propensity for it can go away. Also, your treatment may lighten it entirely – or not.

Every person’s melamsa is different. The most important step you must take is to block UV from contacting your skin’s cells.

That means broad spectrum sunscreen on melasma-prone skin every day from sun up to sun down. Using a product with iron oxide will help, too, because even visible light can trigger melasma and iron oxide at 3.2% or higher has been shown to help.

The second most important step is to turn down your skin’s own normal pigment synthesis (production).

You do that with skin care products. I made my Pigment Repair and Sun Damage Kit as a complete skin care routine to help tough skin pigment problems. Remember that we see sun damage and inflammation in melasma-prone skin. My kit includes antioxidants to help balance skin immune reaction. It also contains ingredients like retinol to help reverse signs of sun damage. If you have melasma, read through the information on my kit page to see the skin care ingredients and routine I think best help melasma and that are available without prescription.  

Still want more answers about melasma?

To read more about melasma, see my update from the 2018 American Academy of Dermaotlogy Symposium on Melasma here.

You can learn more about my Pigment Repair and Sun Damage Kit here.

 

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