Yahoo Lifestyle Dealing with Weird Dark Patches? Melasma May Be the Culprit—Here’s What To Know
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The skin is the largest organ. Unlike internal organs, it's also visible every time we look in the mirror. If you have a chronic condition like melasma, it can be startling.
Back up, what is melasma? It's a common skin condition that causes dark patches to appear on the face, usually the forehead, cheeks, nose, and chin, says Dr. Ife Rodney, MD, a board-certified dermatologist and founding director of Eternal Dermatology. “While it is completely benign and does not itch or hurt the skin, it can cause be emotionally challenging and lead to self-esteem issues,” she says.
It might help lower some anxiety to know you're not alone and even famous faces have dealt with melasma. Stats vary widely, but it's estimated that between 1.5% and 33% have the condition (and up to 50% of pregnant people). Pretty Little Liars star Shay Mitchell fit that bill and documented the intense pulsed light (IPL) therapy procedure she received to treat her melasma in 2020 on Instagram.
There's no cure for melasma, but it can be treated. Here are a few things to know about the skin condition, including what it looks like and how to minimize its appearance.
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What Causes Melasma?
The exact cause of melasma is unknown, says Dr. Robert Finney, MD, a board-certified dermatologist in New York City. But it’s believed to result from the skin’s pigment-producing cells being overactive and producing too much pigment or melanin.
Dr. Rodney explains that melasma is much more common in women, but men do occasionally develop the condition. It’s most commonly caused by sun exposure, hormonal changes and genetics. “Sun exposure is a major trigger of melasma, which explains why it mostly occurs on the face and is more noticeable during the summertime,” she says.
Often referred to as the “mask of pregnancy,” hormonal shifts of pregnancy or from taking birth control pills cause melasma, says Dr. Debra Jaliman, MD, a board-certified dermatologist in New York City and author of “Skin Rules: Trade Secrets from a Top New York Dermatologist.” She estimates that about half of pregnant people develop melasma.
“Pregnancy hormones cause the skin to be more sensitive to sunlight,” she says. “Sometimes, there is just no clear cause. It's more likely to develop when a person has a family history of melasma.” Dr. Rodney says that people with darker skin tones are also more likely to get melasma.
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What Does Melasma Look Like?
Melasma appears as a dark brown discoloration on the skin. Dr. Jaliman says it’s often more noticeable on darker-toned skin because “the more melanin you have, the more prone you are to melasma.”
Though melasma mostly occurs on the face, it can appear on other parts of the body exposed to the sun, like the forearms and neck, Dr. Rodney says. On the face, the dark patches are usually evenly distributed and appear jagged around the edges.
Can You Prevent Melasma?
Melasma is not totally preventable, especially if you’re predisposed, Dr. Finney says. But once it’s diagnosed and treated, there are some preventative measures that can prevent melasma flare-ups. “Because UV exposure is the most common exacerbating factor, many prevention strategies are at protecting the skin from harmful UV rays,” he says. Minimizing sun exposure and following a healthy skincare regimen that includes a retinoid can help combat hyperpigmentation.
One of the best things you can do for your skin? Use a broad spectrum physical sunscreen, which contain zinc oxide or titanium dioxide, of at least SPF 30, Dr. Rodney recommends—and don't forget to reapply it throughout the day. Physical sunscreens more effectively reflect the sun’s harmful rays, while chemical sunscreens, containing compounds like oxybenzone and octinoxate, absorb ultraviolet light from the sun and convert it into heat energy. “Because heat also worsens melasma, chemical sunscreens are a no-go,” she says.
Over-exfoliation from harsh cleansers or scrubs can also irritate and inflame the skin, making melasma worse. “It’s important that you understand that having melasma means that your skin is sensitive, and you should practice a gentle skincare routine,” Dr. Rodney says.
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How To Treat Melasma
Melasma is a chronic condition that can be tough to treat. Dr. Rodney says, “This is mainly because even when we can resolve the discoloration, it quickly returns. It requires constant and ongoing treatment and sun protection.”
Making sunscreen an essential part of your skincare routine is a key step in treating melasma and protecting your skin from a host of other problems. To try to treat melasma at home, Dr. Finney recommends products containing hydroquinone, kojic acid, phytic acid or tranexamic acid.
Products containing niacinamide, vitamin B3, and vitamin C also help treat melasma, Dr. Jaliman says. “Niacinamide helps even skin tone,” she says. “It is a potent antioxidant. Tyrosine in the skin is converted into melanin, which is the pigment that darkens skin by way of an enzyme called tyrosinase. Vitamin C inhibits that enzyme so less melanin is made so the skin gets lighter. This is why topical vitamin C improves dark discoloration.”
If over-the-counter products aren’t helping your melasma, visit your dermatologist, who can prescribe oral and topical treatments such as oral tranexamic acid or skin-lightening creams, Dr. Finney says. Chemical peels, microneedling and platelet-rich plasma therapy can also help treat melasma. Still, he says some higher-energy laser treatments, including IPL, may only help initially and could cause an “angry resurgence of pigmentation not too long after treatment.”
A small 2024 study of 15 people suggested microneedling radiofrequency (RF) could help with melasma maintenance treatment.
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How To Minimize The Appearance Of Melasma
You can control melasma with treatments, but it probably won't go away completely. “Even with the best treatments, melasma may not completely resolve,” Dr. Rodney says. “The good news is that there are options to help reduce the appearance of the discoloration.”
She recommends applying a full-coverage concealer matched to your normal skin tone to the discolored areas. Tinted sunscreens offer double benefits: protecting the skin from the sun and evening out your skin tone.
Skin-lightening creams can minimize the appearance of melasma. Dr. Jaliman says topical vitamin C improves dark discoloration, white mulberry extract evens skin tone, and bearberry extract contains alpha arbutin, which has been shown to lighten the skin quickly.
“There is no cure for melasma,” Dr. Finney says. “It’s something that always wants to come back, thus patients becoming religious with their skincare and preventative measures is imperative. An added benefit of a good melasma skincare routine is that there are a lot of good ingredients that are also anti-aging in there.”
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Sources
Dr. Ife Rodney, MD, a board-certified dermatologist and founding director of Eternal Dermatology
Dr. Robert Finney, MD, a board-certified dermatologist in New York
Dr. Debra Jaliman, MD, a board-certified dermatologist in New York City and author of “Skin Rules: Trade Secrets from a Top New York Dermatologist"
Sun-damaged Skin (Photoaging). Cleveland Clinic.
Targeting the dermis for melasma maintenance treatment. Scientific Reports.
