Melasma : The Tricky Pigmentation

Melasma – what is it and how do we treat it? Can you remove it permanently? How does it appear? How do you tell the difference between hyperpigmentation and melasma? Let’s break it down and answer these frequently asked questions!

Melasma is in fact a type of hyperpigmentation. It is characterized by its appearance and location on the face. Melasma presents as a blotchy or freckled pigment that is brown or blueish-grey. It can show up around the mouth, on the upper lip, nose, upper cheekbones or on the forehead. Less commonly, it may also appear on the back of the neck and shoulders.

Melasma happens due to an overproduction of melanin. Melanin is the pigment that determines your skin coloring. When the cells that produce melanin, called melanocytes, produce too much melanin, it appears on the skin as hyperpigmentation. Melasma is a specific type of hyperpigmentation. This common skin condition may occur from a rise in hormones, UV rays, prolonged light exposure, or excessive heat. You may hear it referred to as the “pregnancy mask” due to its prevalence in postpartum women from an influx of hormones.

Individuals that are affected by melasma may notice the pigment comes and goes with the seasons.  Melasma typically darkens and lightens over time – dependent on the amount of UV exposure or hormonal influx you experience. Often it is worse in the summer and improves in the winter months. Darker skin tones are at a greater risk of developing melasma due to their already higher melanin percentage in the skin. Women are also more likely to develop melasma compared to men, thanks to hormones. About 10% of individuals who are affected are male, with the remaining 90% being female. About 15-50% of pregnant women will be affected by melasma. It is most common during a woman’s reproductive years and rarely happens during puberty. You may notice the first signs of melasma anywhere between your 20’s to 40’s.

So, how do you know if you have hyperpigmentation or melasma? Hyperpigmentation usually does not follow a pattern and/or change with the seasons. It is a constant pigment that is seen anywhere the skin is exposed to UV rays. Most hyperpigmentation is harmless and can easily be treated with creams and/or professional treatments.

Treatment for melasma is different for everyone. This type of pigmentation is very unstable and reacts in a unique way for each person. When starting a course of treatment for melasma, it is best to start slow and with the least aggressive first and then continuing in percentage of severity. Typically, if you experience melasma, you should consider Hydroquinone cream. Hydroquinone is a medical ingredient that works to calm down the overactive melanocytes that are producing too much pigmentation. With continued use, it will also start to lighten the melasma. [IMPORTANT: This product should not be used for longer than 6 months before taking a break.] In conjunction with your Hydroquinone cream, you may be advised to start in clinic treatments. Some of the treatments that may be recommended for you are: chemical peels, microneedling, laser pigment treatments or laser resurfacing. Depending on your severity of melasma and experience of your technician/physician, your treatment plan will be uniquely curated to your skin. The most important thing to remember when treating melasma is: PATIENCE. It takes time to remove/improve the pigmentation as we need to treat slowly and safely.

Unfortunately, just because the pigment can be removed or improved, it does not mean it is a permanent fix. Melasma is treatable and maintainable but it is not a permanent fix. If you have a diagnosis of melasma, this is a condition you will need to maintain long-term. You may be recommended to switch up your skin care regimen and add in lightening creams, regular exfoliants or retinols. These products will help to reduce the severity of the melasma. You should ALWAYS use SPF, especially if you are affected by melasma. Exposure to UV rays is guaranteed to worsen this type of pigmentation. Protect your skin by wearing a medical-grade SPF30+ that is a physical block. Look for titanium dioxide and zinc in your sunscreen. These ingredients create a barricade on the skins’ surface and do not let any type of UV rays penetrate the skin. Remember to reapply every 2 hours when outdoors. Sun protection, a tailored skin regimen and professional treatments will help you feel more confident in your own skin and not so focused on the melasma. Trust the professionals. Clearer skin is just one appointment away.