Skin, Lip and Body Care

How to Deal with Stubborn, Frustrating, Blotchy Skin: Melasma

+ Pamela Friedman

When it shows up for the first time, you don’t know what to think.

Were you out in the sun too long? Maybe it was hotter than you thought.

You imagine it will fade away. Weeks pass and it’s still there.

Those blotchy, dark patches on your cheeks, forehead, and chin. You start to get a little irritated and step up your exfoliation.

Another month passes and it’s still there. Argh. Your skin has lost its uniform appearance, and you’re having to use more and more concealer. Is there nothing you can do to solve this whatever-it-is?

If you relate to this little scenario, you may have melasma. It’s a frustrating, but common skin condition that occurs most often in women 20-50 years old. Unfortunately, it can be difficult to get rid of, so we wanted to help.

Just what can you do to get your old skin back again?

What is Melasma?

Melasma is a skin condition in which light to brown or grayish patches develop on the face, usually on the cheeks, forehead, jawline, and chin. The name comes from the Greek word malas, which means “dark” or “black.”

Melasma can affect anyone, but women are more at risk because of hormonal changes. The condition is so common during pregnancy that it’s often called “the pregnancy mask.” Women who take birth control pills are also at risk, and of course, sun exposure plays a large part in darkening those patches.

Melasma may look like a dark tan at first, but you can identify it by its patch-like appearance. The darker areas are not uniformly dark, but have areas of lighter skin within them, so they look blotchy.

We don’t know exactly why melasma shows up, but it often seems like it’s out of the blue. You aren’t likely to remember any particular occasion that spawned those dark spots. Instead, you’ll probably just look in the mirror one day and see them, or you may notice that you’re using more makeup than before.

Fortunately, melasma doesn’t present any real danger. It’s not attractive, but it doesn’t itch and it doesn’t feel sore, and it’s not related to any other skin problems. The main issue is that it just doesn’t look good, and that’s enough to upset most women.

5 Treatments for Melasma

So far, we have no cure for melasma, which means that women are left to try to fade those patches as best they can.

The typical doctor-recommended treatment is hydroquinone, which is a derivative of benzene that is known to lighten dark patches of skin. We advise women to avoid this chemical, though, because it can damage skin over the long term. In some people, it can increase risk of a rare skin disorder called “exogenous ochronosis,” which causes additional darkness where the product was applied. It may also contribute to the degeneration of collagen fibers.

There are many other treatment alternatives, though, that can help lighten the skin. The important thing is to be consistent with your treatment, and to be vigilant about sun protection. Most skin-lightening solutions increase sensitivity to the sun, and sun exposure darkens melasma patches.

Vitamin C

Vitamin C naturally fades dark spots, so get yourself a quality serum and use it every day. It also helps protect against damaging UV rays, so it’s a great thing to add to your daily regimen, along with your sunscreen.

Skin Acids

There are a number of acids now recommended to help lighten melasma. These include azelaic acid, kojic acid, glycolic acid, lactic acid, and retinoic acid. These are all safe to use, and help to gently slough off the top layer of skin, gradually lightening those blotchy areas.

Exfoliate Regularly

You need to be continually sloughing off that surface layer to stay ahead of melasma, so exfoliate at least a couple times a week. As long as your skin tolerates it well, you can do more. Just avoid harsh scrubs that tear and inflame skin.

Cosmetic Procedures

If you’re not having any luck with the topical solutions, you can try checking with your dermatologist on some cosmetic procedures. A chemical peel or microdermabrasion treatment may help jumpstart your results. (You may want to avoid laser treatments, as the heat can make melasma worse, and they can also cause scarring.)

Just be sure you understand all the risks, particularly with laser treatments, as they can cause scarring in some cases.

Protect from the Sun

The longer you have melasma, the more you’ll realize how critical it is to protect from the sun. Most women notice a darkening of the patches in the summer, and a lightening in the winter. That means you have to be really obsessive about sun protection. Use a physical sun block like zinc oxide or titanium dioxide on a daily basis, and avoid the intense rays that come out between 10:00 a.m. and 3:00 p.m. Use umbrellas and hats. Just one day of exposure can erase weeks of progress.

Stay Cool

There is a “heat” factor when it comes to melasma. Scientists have found that when you get hot, such as when you remain outside on a hot summer day, or during intense exercise or hot yoga, you can trigger melasma patches to form.

Of course, you need to exercise for your overall health. To avoid making your melasma worse, do your best to keep cool. Have cold water nearby and hydrate often, run a fan nearby, and exercise in the cooler hours of the morning and evening.

How do you deal with melasma?

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