Melasma – You Don’t Have to be Pregnant

January 8, 2020

Known sometimes as “the mask of pregnancy,” there’s more to melasma than folklore. The patches of darkened skin that characterize melasma can appear anywhere, but sun-exposed areas such as the forehead, cheeks, chin, upper lip, or nose are frequently where the unwanted concentrations of pigment are found. Although hormones – and the changes that come with pregnancy – can be a precipitating factor, sun exposure is often enough to bring it on for some people. And 10% of people who have melasma are men.

Melasma is not a threatening disorder, but it can be challenging to address, and although some appearances are temporary, it can last a long time in other cases. “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. Though it is not painful and doesn’t represent a health risk, melasma can cause emotional distress for the estimated six million women who develop the dark patches that come with it.

Where It Comes From

Melasma occurs when pigment-producing cells become hyperactive, producing too much pigment in certain areas of the skin. The same could be said for what we call sun spots, age spots, or freckles, yet with melasma, the dark patches cover larger areas of skin. Misinformation abounds and treatment can be difficult, because there can be so many different causes for melasma, depending on each person’s genetics and hormone activity, among other factors. The two most common causes are sun exposure and hormones.

Hormones come into play not only with pregnancy, but also with oral medications including contraceptives and hormone replacement therapies. Melasma can set on when medications are started or stopped, because it is the fluctuation of hormone levels that appears to be a trigger.

Still, sun is considered the biggest culprit. It can be the missing piece, as melasma, even in a person undergoing hormonal changes, appears only after the person begins to get more sun, whether in the coming of summer or a vacation to a warmer climate. Ordinary sunscreens are not enough to prevent this in persons susceptible to melasma, because UV radiation is not the only part of the spectrum that triggers the overproduction of pigment in melasma. Visible light and even heat can also stimulate the onset.

What to Do

Because so many things might resemble melasma, the first step in treatment is to confirm with a board-certified dermatologist that the darkened skin is, indeed, melasma. Then, you are also in the right hands to help determine the cause or causes in your particular case. Oral treatments are available, and their effectiveness depends on identifying the correct cause. Even with the right medication, lifestyle adjustments may be in order, because its positive effect can be neutralized if triggers are still present. In some cases, we treat melasma with laser technology, such as our Halo and Spectra lasers.

At Dermatology Consultants, you’ll find professionals, resources, and the experience to help identify and address melasma, or any skin disorder that might be troubling you. We are here to help you achieve the look you desire and enjoy the feeling that comes with well-being. Just contact us to get started.


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