Melasma and the Sun

What is melasma?

Melasma is a common skin condition consisting of patches and spots of skin that are darker than the surrounding area. These flat skin patches appear gradually and may be brown, grey, or bluish. Fortunately, these discolored areas of skin aren’t itchy, painful, or contagious. This hyper-pigmentation commonly occurs on the face – forehead, cheeks, nose, and upper lip. Melasma can also appear on your neck, forearms, or any area of skin exposed to sunlight.

UV light can trigger the over-production of melanin, which can cause the darker-pigmented skin of melasma. Melanin is the pigment that dictates your eye, hair, and skin color. Melanin production can be influenced by sunlight, hormones, race, and other factors.

Who typically gets melasma?

Women between the ages of 20-40 are significantly more likely to experience melasma, as are women with a darker skin tone. Birth control pills, hormone replacement therapy (HRT), and drugs that cause photosensitivity to UV light can also trigger melasma.

Estrogen and progesterone hormones may play a role in this process. Many pregnant women experience melasma due to higher levels of these hormones. These darker skin patches and spots are frequently called the “mask of pregnancy”. Melasma may also run in families so if a family member has it, you have a higher chance of having melasma.

Will melasma go away?

While melasma is a common and harmless skin condition, it may cause self-consciousness or even embarrassment. For some women, melasma fades after childbirth, stopping birth control pills, or discontinuing hormone replacement therapy. For others, it can take months of treatment until melasma clears up. It may also subside during winter months but darken in summer due to increased sun exposure.

How is melasma treated?

Visit a dermatologist ASAP to determine whether your skin discoloration is due to melasma or another skin condition. Be sure to select a dermatologist familiar with melasma to get the best management and treatment for your skin concerns.

Treatment usually starts with topical creams and gels, but may also include oral and cosmetic treatments like in-office laser therapy or chemical peels. If you’re pregnant, avoid over-the-counter (OTC) treatments unless your dermatologist recommends one. Melasma can be stubborn - even with professional treatment - so it can sometimes take months to see results.

Can sun protection help?

Using effective sun-safe measures is essential to minimize melasma, protect treated areas, and minimize recurrence. Since it’s not always realistic to avoid UV exposure, many sun-smart strategies can help to keep your skin safe while you’re outdoors. These strategies include:

  • applying a broad-spectrum sunscreen with iron oxide and SPF 30 or higher every two hours
  • wearing a wide brim hat and UVA/UVB sunglasses to shield your face, ears, eyes, and neck from sunlight
  • dressing in clothing and accessories that cover your upper and lower body • avoiding the sun from 10-4 when UV rays are the most damaging
  • using a lip balm with SPF protection
  • finding shade when possible

Check your skin monthly for any unusual skin spots. Women over age 20 can perform their monthly skin and breast self-exams on the same day. In addition, all adults should schedule yearly visits with their dermatologist for a full-body skin exam.

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