Melasma. As if our body doesn’t go through enough changes during pregnancy or hormonal changes, do we really have to deal with a brown mask on our face as well? 

First, what causes Melasma? Although we do not totally understand all of the causes of Melasma, we do know a main trigger is hormonal changes, especially while pregnant or taking hormones (such as birth control). Estrogen is capable of accelerating the production of melanin in the skin by enhancing the activity of tyrosinase leading to a darkening of pigmentation. Other potential causes are related to thyroid disease and genetic susceptibility. We also know UV exposure, skin care products that can irritate the skin, and excessive heat can also worsen Melasma. 

Now we know the causes, here are some tips and tricks on how to prevent & treat it. 

Just like any other brown spot, sun exposure is the most significant culprit of Melasma worsening. Even brief UV sun exposure with unprotected skin can reverse all of your hard work treating it. Also, if you have followed me for any length of time you have most likely heard me talk about sunscreen with either titanium or zinc instead of the common chemical sunscreens. This is even more vital with Melasma. A chemical sunscreen transfers UV rays into heat energy, which actually can worsen Melasma. A physical sunscreen (like titanium or zinc) instead provides a barrier to the skin so the UV rays aren’t absorbed. Wearing sunscreen every single day (And reapplying with a powder sunscreen like Colorescience) is crucial to preventing and treating Melasma. 

Wearing antioxidants on the skin applied in the morning is another great way to prevent and treat Melasma. My favorite is CE Ferrulic, which is also safe to use during pregnancy and nursing! 

Wear a wide brimmed hat. Not sure about the benefits of wearing a hat? Check out my previous blog about the importance of hats and the pitfalls. And you can also wear a hat during pregnancy :) 

Wearing a hat plus sunscreen and Melasma is still worsening? I have bad news if you are living in the south-excessive heat can also worsen Melasma. Try to seek shade whenever possible. 

Hydroquinone is a gold standard for treatment of Melasma. Although some products are sold over the counter, you will need a higher percent found in a medical office like 4% found in ZO or Obagi lines, or one compounded by a pharmacy. Medical offices may also carry a compounded hydroquinone with tretinoin and hydrocortisone which expedites the results! Your medical provider will explain how to use hydroquinone as well as the breaks you should take from use. 

Unfortunately, hydroquinone is not safe to use during pregnancy and therefore I suggest patients switch to Lytera 2.0 by Skin Medica to reduce pigmentation. You can use a low percentage of glycolic acid to speed up results as well! 

Discoloration defense by skin ceuticals explores a new gem in the treatment of pigmentation: tranexamic acid. Tranexamic acid diminishes the UV exposure inflammatory pigmentation response.  Discoloration defense also contains Kojic Acid. Kojic Acid is a great natural acid found in fungi that lightens the skin by inhibiting melanin production. It is safe for continued use, especially when taking a break from hydroquinone. 

You can also get individual Kojic acid pads. This typically isn’t your only form of treatment for Melasma, but is a great addition to treatment. 

Chemical Peels can work wonders when performed by trained professionals like those at the Aesthetic Center. When the right series of peels are chosen for your skin, you can see drastic improvement! This may require 2-3 days of downtime with some light flaking/peeling. 

I typically am not in favor of many laser treatments available when treating Melasma. There is a chance laser can actually worsen/darken Melasma, so unless you have a very trained professional with advanced dermatologic experience that can recognize the difference between sun damage and Melasma, stick with the above treatments! 

Questions? You can always come in for a free facial analysis at the Aesthetic Center! Just call 615-567-6300