If you’ve noticed patches of dark, symmetrical, and brown appearing on your cheeks, forehead, lips, or bridge of your nose, then chances are that you’re suffering from melasma. Sometimes called the ‘mask of pregnancy,’ this condition involves dark patches appearing on the skin, which are darker than the regular tone of your skin. While not dangerous physically, finding an effective Melasma treatment is notoriously difficult to get rid of.

Causes of Melasma

Melasma is caused by the overproduction of skin pigment by melanocytes in certain parts of the body. Unlike sunspots, melasma is caused by a combination of different internal and external factors:

  • Hormones: Increased levels of estrogen and progesterone hormones activate melanocytes. That’s why melasma often occurs during pregnancy or when taking contraceptive pills.
  • Ultraviolet (UV) Light: UV light coming from the Sun is an external factor that causes melasma. Even a brief stay under the Sun with no protection will make your melasma patches appear again.
  • Heat and Visible Light: Heat in the form of infrared from saunas, hot kitchens, and exercising intensely, as well as high-energy visible (HEV) blue light emitted by digital devices, can also lead to inflammation of the melanocytes and exacerbate hyperpigmentation.
  • Genetics and Skin Color: The condition is more prevalent among people who have moderate to dark-colored skin due to the increased amount of active melanocytes in such skin type.

Treatment for Melasma

A long-distance race approach is needed for the treatment of melasma. Since the pigment sits on various layers of the skin, a multi-layer Melasma treatment protocol is more effective:

1. Rigorous Sun Protection

The treatment will not be effective without this step. One needs daily application of a broad-spectrum mineral sunscreen that contains zinc oxide or titanium dioxide. One should choose a tinted product since iron oxides included in tinted sunscreens are the only ingredients that block HEV light.

2. Topical Medications

Your dermatologist will normally initiate the use of creams to prevent the development of pigment in the skin. The best choice is either Hydroquinone or Triple Combination Cream (a mixture of hydroquinone, retinoid that hastens cellular turnover, and steroids to minimize inflammation). Good non-hydroquinone substitutes include azelaic acid, kojic acid, and vitamin C.

3. In-Office Treatments

Should topicals prove ineffective, professional treatments such as superficial chemical peels, microneedling, or even low-energy laser (Picosecond laser) can hasten clearance. Note however that lasers create heat and since heat causes melasma, these should be carefully done under a professional’s guidance to avoid rebound darkness.

In any case, although melasma is not completely curable, it can be effectively managed with the right long-term Melasma treatment strategy.