Melasma appears when pigment- producing cells become hyperactive and produce too much pigment in certain areas of the skin. The mechanism is similar to what causes brown age spots and freckles, but melanoma patches tend to be larger. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It can also appear on other parts of the body that get lots of sun, such as the forearms and neck.
Melasma is more common in women, but is can also affect men. There may also be a genetic component, as it often runs in families. People with a darker skin type are more likely to get melasma, probably because that type of skin naturally has more active pigment- producing cells.
Melasma is sometimes referred to as the mask of pregnancy, because it is sometimes triggered by an increase of hormones in pregnant women. But while the condition may be common among pregnant women, it isn’t limited to them. Melasma can affect women at all stages of life. And it may last for many years. “Women who develop melasma in their teens or 20s or 30s may see it stay around for decades” says. dr. Barbara Gilchrest, senior lecturer on dermatology at Harvard Medical School.
Melasma has several different causes. However 2 in particular stand out:
Sun exposure. In triggering melasma the sun is the big culprit. Underlying factors such as hormonal changes may not manifest until a person goes on vacation to a sunny location, or during the summertime when more time is spent in the sun. The sun is the major exacerbating factor, whatever the underlying cause. Also melasma can be caused or worsened not only by sunlight, but also by heat and visible light. Unfortunately this means that even sunscreens that protect skin against skincancer aren’t enough to protect against melasma. That’s why treating melasma in the summer months is particularly a challenge.
Hormones ( including hormonal medications). Melasma can also be caused by fluctuations in certain hormones, which is why it commonly occurs during pregnancy. Melasma is also known to occur when one either starts or stops hormonal contraception, including birth control pills, or when one takes hormone replacement therapy. If a hormonal contraceptive is causing the problem, a woman might consider switching to a non- hormonal option
When treating melasma the first step is confirming with a dermatologist that the darkened skin patches are indeed melasma and what has caused it. If the underlying cause isn’t determined the treatment of melasma is unlikely to be effective.
Avoiding the sun
The next step in treating melasma is preventing the sun from aggravating the skin condition. For this extreme perseverance is needed. The sun is stronger than any medicine you can give. A strict sunscreen regimen is needed to clear up melasma. However, to prevent melasma a sunscreen is needed that doesn’t only block sun rays, but also it’s light and heat.
When choosing the right sunscreen, it’s important to know that there are 2 main types;
sunscreens that contain chemicals, f.e. oxybenzone
sunscreens that contain physical blockers, f.e. zinc and titanium dioxide
It’s best to choose the non- chemical, blocking sunscreen. This type will stop all the light and different wavelengths from coming through. Nowadays the zinc and titanium dioxide formulas are micronised so they can sink into the skin, and at the same time offer protection.
When it comes to chemical sunscreens it’s important to know that they don’t offer the same protection as the non- chemical ones. And that they in some cases may even trigger allergic reactions that can make melasma worse.
Even in the fall and winter it’s a good idea to wear a sunshield or a hat that’s designed to provide sun protection, when going outside for an extended period of time.
Topical treatments and medications
Some commonly used options to treat melasma are topical rationales and retinoid treatments. These are applied to the skin to help speed the body’s natural cell turnover process. Dark patches may clear more quickly than they would on their own.
Hydroquinone or peels are also an option when it comes to the treatment of melasma. But it’s best to use these only under doctor’s care.
Be sure to wear your Bluestone Sunshield all year round to prevent melasma from occuring/worsening!