Melasma is a common skin condition in which brown patches, splotchiness appear on the skin on the forehead, cheeks, upper lip, or jaw line. It is triggered by hormones and light. Melasma is essentially too much dark pigment. Called the “mask of pregnancy”, it often appears in the second and third trimester. Other risks for melasma are birth control pills and estrogen replacement therapy in menopause. Melasma is also common in people who live in tropical climates. Being out in the sun for too long and too often puts you at risk for this condition. Women with darker complexions are also more likely to get it and it is a significant problem for many.
Hormones stimulate the growth of cells that make brown pigment (melanocytes). And natural light stimulates the production of even more brown pigment (melanin). So you have two problems: too many cells making brown pigment and sun light constantly stimulating them.
If you do get melasma during the pregnancy, chances are it will disappear after delivery. Rarely, it gets worse over time and with exposure to sunlight. Melasma tends to become worse with subsequent pregnancies, particularly if the pregnancy is during the summer. The longer you stay on the oral contraceptives, the greater the chance the melasma will become a permanent problem.
Treatment for Melasma
Avoid the sun ! Melasma gets worse over time with exposure to sunlight. If you are pregnant, particularly in the summer, be sure to apply a SPF fifteen or greater with zinc, titanium, or mexoryl every single morning and reapply it frequently. Or, layer an SPF 15 under an SPF 30.
You should also wear a hat.
Nonprescription “bleaching” creams don’t really “bleach” the brown spots. Instead, they block the production of excess pigment in the skin. They only work if your problem is minimal. They contain 2% hydroquinone. Prescription “bleaching” creams contain 4% hydroquinone (HQ4%) and other active ingredients.
Other procedures include chemical trichloracetic acid,TCA, peels and microdermabrasion to help lighten dark patches.
At Medical Laser and Rejuvenation, we use a prescription hydroquinone, Tri-Luma, often along with the Micropen needling system which stimulates collagen production and create microscopic canals for the hydroquinone. You will not have success treating melasma if you don’t block light. Every time ultraviolet light hits these brown spots it makes them worse. Your sunscreen must block UVA and UVB rays and should have SPF 30. Double sunscreen especially on the areas where you have the most blotches.
Learn about the Micropen here!
For more information, or to schedule an appointment, please call our office!
Medical Laser & Rejuvenation
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Information provided on this website and in the Doctor’s Blog is for informational and educational purposes only. It is not intended as and does not substitute for medical advice. Please consult your health care professional for evaluation of your individual case.