Melasma: What It Is, Who It Affects & How Best to Support Your Skin
For those of us who have ever glanced in the mirror only to discover brownish patches blooming on our skin, we know all too well the confusion that soon follows. We’re talking about melasma, a common chronic skin condition that can cause concern and frustration for those affected by it. We know firsthand the feelings melasma can elicit, so we’re diving in headfirst to demystify this skin condition with scientific facts.
Read on for more on melasma—and discover how you can get back to loving that beautiful face in the mirror, once and for all.
What Is Melasma?
Melasma is a common chronic skin condition that results in light to dark-brown—sometimes grey—pigmentation of sun-exposed skin on the face, though it can occasionally appear on the body, including on the forearms, neck and shoulders. In general, though, the cheeks, bridge of the nose, forehead, chin and the upper lip are the most commonly affected areas.
Melasma occurs when the production of melanin—the pigment that defines the color our of skin— increases within layers of the skin. Oxidative stress (think free radical damage, like that caused by UV rays) causes this increase by launching the tyrosinase enzyme within the melanin cells. Once the damage from this oxidative stress occurs, melanin production is increased, resulting in further skin pigmentation.
Melasma vs Hyperpigmentation?
Of course, not every dark spot on your skin qualifies as melasma. Hyperpigmentation from sun spots, age spots, birthmarks and scarring or discoloration from acne, eczema or skin rashes can also alter the pigmentation of the skin.
If you’re in your 30s and 40s and begin to notice a random pattern of flat brown spots on the sun-exposed parts of your body (face, shoulders, back and neck), these are most likely sunspots. And—good news!— like the discoloration that occurs after an inflammatory response like acne or eczema, they’re often responsive to topical skin brightening treatments that help them fade away.
Melasma, by contrast, tends to form a specific pattern of pigmentation. It often starts with clusters of freckle-like dark spots that eventually spread to a larger area on your face. Typically, it gets darker from sun and heat exposure in the summer and will fade slightly over the colder winter months. In women, it becomes more visible with monthly hormonal fluctuations.
Who Does Melasma Affect?
You may have heard of melasma referred to as “the mask of pregnancy,” as hormonal fluctuations can cause short-term melasma (known as cholasma) that typically fades away after pregnancy. While this condition isn’t limited to pregnant women, hormones do seem to play a part: Hormonal birth control and changes caused by an onset of peri-menopause or menopause can also result in melasma.
But part of the frustration associated with this skin condition is that it’s not limited to just an influx of hormones; both genders and any ethnicity can be affected by melasma, though according to the American Academy of Dermatology, it’s significantly more common in women: 90% of all of those diagnosed are, in fact, women. Those with darker skin tones are also more susceptible, especially people of Latino and Asian descent.
What Causes Melasma?
Unfortunately, melasma is considered a complex and multi-factor skin condition and its exact underlying causes are still unknown. Often, melasma forms due to a combination of factors.
According to the American Academy of Dermatology, the most common melasma triggers include:
- Sun exposure
- Genetic predisposition
- Hormonal fluctuations
- Certain harsh chemicals found in skincare products
Melasma and Sun Exposure
We all love the feel of warm sunshine on our skin! But sun exposure is considered the primary trigger for developing melasma. Photo-damage from UVA and UVB rays exposes skin to harmful free radicals that can trigger hyperpigmentation. Melasma can occur year-round, although increased hyperpigmentation and melasma typically develop or become more noticeable in the sunny summer months. Your best bet is to reach for that SPF every time you leave the house. (But you knew that already!)
Melasma and Genetics
Those with darker skin types have a genetic predisposition that puts them at a higher risk of developing melasma. In addition, if you have a family history of melasma, you’re also at a higher risk, as it can be passed onto children from both sides of the family.
The most common skin tones—which can be accurately identified by your dermatologist— affected by melasma are:
- Darker white skin which typically develops a tan after an initial burn.
- Light brown skin that tans easily and experiences minimal burning.
- Brown skin that develops deep tan very easily and almost never burns.
Melasma and Hormones
According to Harvard Medical School, research shows that elevated levels of estrogen—and to some extent, progesterone—can increase skin pigmentation. It’s no surprise, then, that significant hormonal changes, such as those due to pregnancy, birth control use, and hormonal replacement therapies are an important trigger for developing melasma.
Melasma and Skincare
Let’s face it: We love our skincare. From moisturizers and masks to treatments promising wrinkle reduction, we invest a lot of time, loyalty and money into our beloved skincare routines. But many of the skincare products on the market today contain harsh chemicals that can irritate the skin. As a result, this irritation may cause a response that leads to excess melanin production—and that means the formation of— or worsening of—skin hyperpigmentation. The best part? You don’t have to forego a great skincare routine. Just be sure to reach for products that are gentle and formulated with safe ingredients, as this may avert melasma formation and prevent it from worsening.
How Is Melasma Diagnosed?
So, how do you know if what you’re seeing in the mirror is melasma? An experienced dermatologist can visually diagnose melasma, but to ascertain its depths, they’ll need to perform the Wood’s Lamp exam, which uses a special black light to determine different skin conditions. This exam helps to determine if the melanin is present in the inner or outer skin layers—or both. Some doctors may also perform a skin biopsy by removing a small portion of the skin for further examination by a lab.
There are three types of melasma, determined by the affected layer—or depth—of the skin:
- Epidermal Melasma: Characterized by hyperpigmentation in the outer skin layer, epidermal melasma is typically easier and faster to brighten with topical treatments
- Dermal Melasma: The most challenging to treat, dermal melasma is located in the deeper layer of the skin. Typically, this type takes much longer to respond to treatments and often requires a multifaceted treatment approach.
- Mixed Melasma: A combination of the epidermal and dermal types of melasma.
How Do I Treat My Melasma?
First and foremost, take a deep breath. While treating melasma is challenging and requires an individualized approach, there are myriad combinations that may help alleviate symptoms. Dermatologists can use a combination of specialized topical solutions such as serums, creams and gels in conjunction with medical treatments, including lasers, oral supplementation, and lifestyle changes.
Melasma treatment is very personal and what works for one person may not necessarily work for you. How your skin responds to treatment will depend mainly on the underlying cause of your skin hyperpigmentation, the depth of melasma, your daily skincare routine and the quality of the skincare you use.
The good news? There are concrete actions you can take to empower yourself in managing your melasma!
Use SPF every day!
When it comes to treating melasma, sun protection should be at the top of your list. In fact, the American Academy of Dermatology says that sun protection is always the top priority! Opt for a physical sunscreen (loaded with protective minerals) with non-nano zinc oxide and titanium dioxide as the main active ingredients. These minerals work to deflect the sun’s harmful UV rays away from your skin, protecting it from aging free radicals, sun damage and a further increase of melanin production. Just make sure to reapply every 2 hours to yield maximum benefits!
In addition to making sunscreen a daily habit, a wide-brimmed hat is an effective (and chic!) tool in your sun protection arsenal. And while the sun is definitely a huge factor in managing melasma, the heat can aggravate it, too—so make sure to cool off and stay hydrated as much as possible!
We know antioxidants can combat environmental stressors and help keep our skin healthy. It makes sense then that in a 2013 study, the National Institute of Health recommended an antioxidant blend of Vitamins C, E and ferulic acid to provide anti-inflammatory support and help to repair skin damage caused by oxidative stress, free radicals and UV damage.
As non-toxic skincare has gained increasing traction over the last several years, options for safe, antioxidant-infused products have become readily available. Whether you choose a treatment serum or a moisturizer, your skin will benefit from an antioxidant blend that protects it from free radicals and inflammation.
Topical Treatment for Melasma
Topical treatments can be a viable part of managing melasma and may yield significant results. But most common prescription melasma treatments include hydroquinone, tretinoin, and corticosteroids—ingredients known for their efficacy, but which can also have serious side effects. If you’re opting to use products containing these ingredients, make sure you follow the directions exactly as written; hydroquinone, in particular, is a very powerful ingredient that if used too long or improperly can actually lead to an increase of hyperpigmentation.
While these ingredients do have proven track records for managing melasma, there are also more gentle—yet still viable—options available. Natural botanical ingredients that act to brighten and inhibit hyperpigmentation are now finding their way into non-toxic, topical skincare and are proving to be effective in managing melasma.
Whenever possible, seek topical solutions that blend antioxidants with ingredients that also brighten and prohibit hyperpigmentation. When we formulated our Rute Elements hero product, Advanced Brightening Serum, we made sure it would not only brighten the skin but that it would protect it from damaging free radicals that can age skin and make melasma worse. We curated natural ingredients that work synergistically to brighten and even out the complexion: Vitamin C, Kojic Acid, Alpha Arbutin, Licorice Root, Gotu Kola, Salix Alba, Niacinamide and other botanical antioxidants. The result is an easy, one-step skincare routine that will supply the skin with everything it needs to regenerate and restore its natural glow with brightened skin pigmentation, including melasma.
Bear with us here. We know skin conditions can be painful to deal with. We understand that melasma can, at times, feel overwhelming while you determine the type of melasma you have and how best to manage it. That’s why we believe sending your skin some self-love is so important. Our thoughts have incredible power over our bodies: We absorb what we believe, and while the stress of skin conditions is all too real, taking a moment every day to thank your skin for protecting you and honoring its beauty—and it is beautiful—can go a long way in caring for your skin on a deep and powerful level. Whether it’s taking a few moments to massage your face and neck while applying your favorite products or smiling as your eyes meet your reflection in the mirror, sending your skin some love will go a long way in helping you navigate your melasma journey.
American Academy of Dermatology -https://www.aad.org/public/diseases/a-z/melasma-overview
Topical Treatment of Melasma -https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807702/
The Role of Sunscreen in Melasma and Postinflammatory Hyperpigmentation -https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986132/