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Melasma, often referred to as chloasma, is especially prevalent in pregnant women. Explore additional images showcasing various skin conditions.
©iStockphoto.com/Paulus RusyantoIf you suddenly spot brownish patches on your skin, you might initially think your freckles have merged or expanded. However, it’s more likely that you’re dealing with melasma. Among the many adverse effects of sun exposure on the skin, melasma stands out as one of the most cosmetically concerning.
Melasma is a relatively common skin disorder that predominantly affects women, with men accounting for just 10% of cases [source: Montemorano]. Individuals with darker complexions, including those of Latin American, Asian, Indian, Middle Eastern, Mediterranean, and African heritage, are more prone to developing melasma compared to those with lighter skin tones.
Melasma manifests as patches ranging from brown to gray-brown, which may merge together or appear as scattered splotches. These patches typically develop on sun-exposed facial areas like the cheeks, nose bridge, forehead, chin, and upper lip, and can also appear on the forearms and neck. The patches are usually symmetrical, meaning if one cheek is affected, the other likely is too. Beyond these cosmetic changes, melasma does not present any other symptoms.
Melasma is categorized into three types based on the skin layer it affects. Epidermal melasma impacts the epidermis, the outermost skin layer, presenting as dark brown patches with clear edges that respond well to treatment. Dermal melasma affects the deeper dermis layer, with lighter brown patches and less defined borders, making it harder to treat. Mixed melasma combines both types, showing partial improvement with treatment.
Melasma is also referred to as "acquired hypermelanosis" or "hyperpigmentation." It is sometimes called chloasma or the "mask of pregnancy" due to its high prevalence among pregnant women [source: Merck].
Continue reading to explore the causes of melasma, available treatments, and why it is so common during pregnancy.
Melasma Causes
Melasma patches appear darker than surrounding skin due to an excess of pigment. These pigments are produced by melanocytes, specialized skin cells. When exposed to ultraviolet (UV) radiation from the sun, melanocytes are stimulated to produce more pigment. This increased production can sometimes lead to melasma. Even after melasma fades, minimal sun exposure can trigger its recurrence.
While scientific research offers insights into melasma, the exact reason it affects some individuals and not others remains unclear. However, certain factors are known to increase the likelihood of developing melasma, including:
- A family history of melasma
- Darker skin -- Individuals with more active melanocytes have higher skin pigment levels, increasing their susceptibility to melasma.
- Tropical climates -- Frequent sun exposure in these regions raises the risk.
- Skin-irritating products -- These can trigger melanocytes to produce excess pigment, worsening melasma.
- Anti-seizure medication
- Phototoxic drugs -- These heighten the skin's sensitivity to light damage [source: Merck].
Research also links melasma to elevated levels of estrogen and progesterone hormones. This connection explains why the condition is more prevalent among pregnant women, those on birth control pills, and individuals undergoing hormone replacement therapy.
Melasma affects individuals differently. To explore treatment options tailored to various cases of this skin condition, proceed to the next page.
More than 30 percent of individuals with melasma have relatives who also suffer from the condition [source: Montemorano]. Research indicates that identical twins often both develop melasma, whereas fraternal twins do not necessarily share the same outcome.
Melasma Treatment
Melasma may resolve on its own over several months, but various treatments are available depending on the type of melasma. Epidermal melasma responds well to treatment, while dermal melasma is more stubborn, often recurring with sun exposure.
A dermatologist can diagnose melasma by examining your skin and may prescribe creams to reduce its appearance. Hydroquinone-based creams, which lighten the skin, are effective in about 30 percent of cases [source: DermNet New Zealand]. Other creams containing tretinoin, corticosteroids, or azelaic acid can enhance hydroquinone's effects [source: Merck]. If skin irritation occurs, consult your dermatologist.
For those unresponsive to creams, advanced treatments like chemical peels, microdermabrasion, and laser surgery may be options. While results can vary, these methods may work faster than topical treatments [source: Montemorano]. However, these procedures require a physician's approval and must be customized to your skin type and melasma condition.
Another option for treating melasma is intense pulsed light therapy, which uses light energy to eliminate the pigmented layer of skin. However, this method is less common, so thorough research and finding a qualified expert are essential before pursuing it.
If you’re dealing with melasma, you likely want to prevent it from spreading. Continue reading to discover whether this is achievable.
Intense pulsed light therapy is a modern approach to treating melasma. It employs light energy to target pigmented skin cells, which absorb the energy and convert it into heat, damaging the problematic cells. This therapy focuses on the dermis, the deeper skin layer, without harming the epidermis, making it particularly effective for dermal melasma. Sessions are brief and typically require multiple treatments per week over three to six weeks [source: DermNet New Zealand].
Melasma Spreading
Melasma is not contagious and cannot spread through contact, so there’s no risk of transmitting it to others. However, additional patches can develop due to factors like prolonged sun exposure without proper protection.
To prevent melasma from spreading, minimize sun exposure, especially between 10 a.m. and 4 p.m. when UV rays are strongest, even on cloudy days. If you must be outdoors, wear protective clothing, a wide-brimmed hat, and use sunscreen with an SPF of at least 15 that guards against both UVA and UVB rays [source: DermNet New Zealand]. Reapply sunscreen every two hours, particularly after swimming or sweating.
Skin care products that irritate your skin can worsen melasma, causing patches to grow or multiply. Be mindful of the products you use in your daily skincare routine.
Consuming foods rich in folic acid can help prevent and reduce the spread of melasma. Research suggests a connection between hyperpigmentation and folic acid deficiency [source: What to Expect.com]. Include green leafy vegetables, citrus fruits, and whole grains in your diet. For instance, starting your day with a glass of orange juice may help combat melasma.
Foods high in folic acid are also recommended for pregnant women to prevent melasma and its spread. To learn more about the link between melasma and pregnancy, continue reading.
Signs of skin irritation from products include burning, itching, stinging, or redness. Harsh reactions to skincare items can also worsen melasma-affected areas. Common irritants include detergents, shampoos, bath soaps, cosmetics, antiperspirants, hair products, and moisturizers [source: American Academy of Dermatology: Facts].
Melasma and Pregnancy
Melasma is so prevalent during pregnancy that it has its own name: chloasma. It is often called the "mask of pregnancy" [source: Merck].
Pregnancy leads to increased levels of estrogen and progesterone, which can boost pigment production in skin cells. Women on birth control pills or hormone replacement therapy are also more prone to melasma. While melasma patches on the face, forearms, and neck typically fade a few months after childbirth, they often reappear with subsequent pregnancies [source: American Academy of Dermatology: Melasma].
Pregnant women should follow the same sun protection measures as others to prevent and manage melasma. However, avoid skin-bleaching creams or treatments until after delivery and breastfeeding. Using concealer to mask melasma is a safer option during pregnancy. Always test new products on a small skin area before use.
Pregnancy-related melasma can also darken naturally pigmented areas like freckles, scars, and genital skin. A dark line, called the linea nigra, may appear down the abdomen and usually fades a few months postpartum.
Regardless of pregnancy status, avoiding sun exposure is the most effective way to prevent melasma and other skin conditions. For additional details, proceed to the next page.
The term "linea nigra" translates to "black line" in Latin, describing the dark line that appears on the abdomen during pregnancy. This line, which runs from the navel to the pubic bone, is always present but usually invisible and referred to as the linea alba ("white line"). It becomes noticeable during pregnancy and typically fades back to its original color postpartum, though this may take several months [source: Baby Center].
