At various points in our lives, we may notice changes in our skin that can be unsettling. One such condition is melasma, often called the “mask of pregnancy,” which commonly appears as brown or grayish-brown patches on the face—most often on the cheeks, forehead, bridge of the nose, and upper lip. While melasma can occur in anyone, it is more frequently seen in women, particularly those with darker skin tones or who are experiencing hormonal changes, such as during pregnancy or while taking birth control pills. Sun exposure and genetic predisposition also play a significant role in its development. Although melasma is not harmful, it can be distressing due to its impact on appearance. Understanding the causes and treatment options is essential for effectively managing this condition.
Melasma Explained
Melasma is a skin condition that causes brown patches with irregular borders to appear on the face (forehead, chin, cheeks, and upper lip) and can also appear on the chest or arms. The exact cause of melasma is still unknown, though certain triggers seem to cause an overproduction of melanin (the pigment in our skin), creating these dark spots. This is not a contagious condition.
This skin condition can sometimes be transient, such as in pregnant women. They will experience skin changes while pregnant, with the symptoms disappearing once they have a baby. Others deal with melasma for years or even the rest of their lives.
What can trigger melasma? The list includes the following:
- Sun exposure
- Pregnancy
- Birth control or hormone treatments
- Certain skin care products
- Some medications, including anti-seizure medication and phototoxic medications
- Tanning beds
Genetics may also play a role, as people with a family history of melasma are at a higher risk of developing it.
A Dermatology Provider can diagnose your skin condition through a visual examination. While melasma does not cause other physical symptoms, it can sometimes look like other skin conditions. It is best to get a diagnosis from a specialist so that you can choose the most effective treatment together.
Are there treatments?
Fortunately, we have some excellent options for treating melasma. For starters, daily sun protection is critical! Use sunscreen with both UVA/UVB protection with an SPF of 30 or higher, a wide-brimmed hat, sun-protective clothing, and stay in the shade whenever possible.
Multiple topical treatments are available. Treatments depend on various factors, including the extent of the pigmentation. Hydroquinone is the most common topical cream. It is available OTC in 2% strength and 4% with a prescription. Other products your Dermatology Provider might use in combination with hydroquinone or alone include kojic acid, azelaic acid, hydroxyl acids, and retinoids. The main goal of these topical creams is to lighten the patches.
Other treatment options include chemical peels such as Glycolic acid or a Jessner peel. A Jessner peel uses a powerful blend of salicylic acid, lactic acid, and resorcinol to effectively treat conditions such as acne, melasma, and sun damage.
Another option is intense pulsed light (IPL). IPL is a good procedure due to minimal downtime and relatively low-risk factors. It can be performed monthly until the desired effects are achieved.
If hormonal issues are triggering your melasma, such as taking birth control medication or hormone treatments, you might want to discuss it with your Provider to see if there are other options you can explore. Melasma can fade after a person stops taking these types of medications.
The key to any treatment is patience. Seeing results may take time, and depending on your situation, you may need a combination of treatments.
Taking Care of Yourself
As with any chronic skin condition, consistent treatment, working in conjunction with your Dermatology Provider, and being proactive in taking care of your skin will help you manage your melasma.
It cannot be stressed enough that UV protection is key to preventing melasma, minimizing the appearance of existing dark spots, and preventing it from recurring if you have had treatment. This means using sunscreen daily, regardless of the weather, season, or if you think you don’t need it because you’re going straight to work. Remember that UV rays penetrate glass, so you will be getting the effects of UV rays through car windows and the office window you may be sitting next to. A broad-spectrum UVA/UVB sunscreen is critical, with a zinc and/or titanium sunblock and an SPF of over 30. Reapply often during the day.
Maintaining a good skin care routine will also keep your skin healthy. Besides sunscreen protection, using a mild skin cleanser and moisturizing can keep your skin barrier up to par. Your Dermatology Provider may be able to recommend skin products that work best for you.
Melasma can be a frustrating chronic skin disorder. However, multiple treatment options are available to help control those patches on your skin. Get the help and treatment you need today!
Consult with one of our Dermatology Providers to get an accurate diagnosis and individualize your treatment. At Dermatology Associates of Northeast Georgia, we have years of experience treating skin conditions such as melasma. If you have any questions or concerns, you can book an appointment at one of our locations in Gainesville, Dahlonega, or Demorest.