Melasma on Face: Causes, Treatments, and Prevention

Melasma on the face is a skin condition that causes dark patches. It helps to know about the causes, treatment, and prevention, as well as how to manage it for healthy, beautiful skin.

Melasma happens due to overproduction of the cells that make the color of one’s skin. It is common, harmless, and few treatments can help. Melasma usually fades after a few months.

Melasma is a common skin disorder leading to blue-gray patches on the skin. They can indeed appear as flat patches or freckle-like spots. Commonly affected areas do include one’s face, including the cheeks, upper lip, and forehead, and also the forearms.

Melasma appears mostly on one’s cheeks, nose, chin, above the upper lip, and the forehead. It can also affect one’s arms, neck, and back. Melasma can affect any part of the skin that is exposed to sunlight. These symptoms worsen during the summer months.

Symptoms and Causes

There are two main causes of melasma: radiation, be it ultraviolet, visible light, or infrared (heat) light; and hormones.

Ultraviolet and infrared radiation from the sun are important in making melasma worse. Other possible causes of melasma include:

Antiseizure medications: drugs that prevent a person from having seizures can be a cause of melasma.

Contraceptive therapy (birth control): Melasma has been observed in individuals who make use of oral contraceptive pills that contain estrogen and progesterone.

Estrogen/Diethylstilbestrol: Diethylstilbestrol is indeed a synthetic (man-made) form of the hormone estrogen. It is often used in treatments for prostate cancer. There is a pattern between increased estrogen and melasma.

Genetics: About 33% to 50% of people with melasma have reported that another person in the family has had it. The majority of identical twins both have melasma.

Hypothyroidism: A condition whereby the thyroid is underactive.

LED Screens: Melasma can be caused by the LED lights from one’s television, laptop, cell phone, and tablet.

Pregnancy: It is unclear why “the mask of pregnancy” does occur to pregnant women. Yet, experts theorize that the increased levels of estrogen, progesterone, and the melanocyte-stimulating hormones during the third trimester of pregnancy do play a role.

Hormones: Hormones such as estrogen and progesterone can play a role in a few people. Postmenopausal women are at times given progesterone and have been observed to develop melasma. If not pregnant, then the woman is likely to have elevated levels of estrogen receptors found in one’s melasma lesions.

Makeup (cosmetics): Few cosmetics can cause what is known as a phototoxic reaction.

Phototoxic drugs (medicines that make the person sensitive to sunlight): These do include a few antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), diuretics, retinoids, and also hypoglycemics, antipsychotics, along with targeted therapies, and a few other drugs.

Skin care products: A product that does irritate the skin in general will likely make one’s melasma worse.

Soaps: Few scented soaps can cause or worsen melasma.

Tanning beds: The UV light produced by tanning beds damages one’s skin just as badly as the UV light from the sun, and sometimes worse.

Symptoms of melasma

Melasma does cause light brown, dark brown, and/or bluish patches or even freckle-like spots on one’s skin. Few of the patches can become red or inflamed. Melasma appears in six locations or a combination of locations on one’s skin.

Brachial: The melasma does appear on one’s shoulders and also upper arms.

Centrofacial: The melasma does appear on one’s forehead, cheeks, nose, and upper lip.

Lateral cheek pattern: The melasma does appear on both cheeks.

Malar: The melasma sort of appears on the cheeks and nose.

Mandibular: The melasma does appear on the jawline.

Neck: In people age 50 or older, melasma can rather appear on all sides of the neck.

One’s healthcare provider will indeed decide for sure if one has melasma or another type of skin disorder.

Foods: No foods or drinks known by experts can directly cause, magically cure or even worsen melasma. Yet, to keep one’s skin healthy in general, try a skin-healthy diet of foods rich in Vitamin D:

• Almond milk.
• Eggs.
• Meat.
• Milk.
• Mushrooms.
• Oily fish.
• Orange juice.
• Yogurt.

Management and Treatment

Melasma is difficult to treat. In order to determine a treatment plan, the healthcare provider will need to initially figure out the cause of   melasma.

Depending on the person, melasma can go away on its own, and it can be permanent or may respond to treatment within a few months. Most cases of melasma will  soon fade away with time and with good protection from sunlight as well as other sources of light.

Unfortunately, there is rather no definitive treatment that will make melasma disappear. There is no way to remove dermal pigment.

If having melasma, be sure to avoid:

Hormone treatments entailing estrogen. oral contraceptive pills that contain estrogen and progesterone, birth LED light from one’s television, laptop, cell phone, and also tablet.

• Makeup that is irritating to the skin.
• Medications that cause or worsen melasma.
• Scented soaps.
• Skin care products that irritate one’s skin.
• Tanning beds.
• Waxing can aggravate melasma.

Further treatment:

Wearing a wide-brimmed hat helps. These steps do prevent melasma from getting worse.

Taking topical medications is another way out. Topical therapy, thus using tyrosinase inhibitors, does prevent new pigment formations by stopping the formation of melanin (the dark color).

Medicines:

Azelaic acid: This cream, lotion, or gel is applied twice a day. It is safe for pregnant women to use.

Cysteamine: This cream is more effective than a placebo.

Hydrocortisone (a topical corticosteroid): Hydrocortisone does help fade the color caused by melasma. It can also lessen the likelihood of dermatitis that can be caused by other agents.

Hydroquinone: This medication is of course applied as a cream or lotion. It indeed goes directly onto the melasma patches at night for two to four months.

Methimazole: Methimazole happens to be an antithyroid cream or an oral tablet. It is known to help melasma that does resist hydroquinone.

Soybean extract: Soybean extract is considered to reduce the transfer of color from the melanocytes to one’s skin cells.

Topical alpha-hydroxyacid: Epidermal pigments, no doubt, can be peeled off. This cream or chemical peel does remove surface skin.

Tranexamic acid: This is a cream, injection, or oral medication.

Tretinoin: This prescription is a topical retinoid. It is effective but can cause dermatitis and should not be used during pregnancy.

Other agents that are being studied to improve melasma include:

• Absorbic acid (vitamin C).
• Arbutin.
• Deoxyarbutin.
• Glutathione.
• Kojic acid or kojic acid dipalmitate.
• Licorice extract.
• Mequinol.
• Resveratrol.
• Runicol.
• Zinc sulfate.

Conclusion

Melasma is indeed a harmless skin condition. It does not itch or hurt, and it does not become malignant. Expect it to get worse and/or reoccur if you do not take steps like avoiding the sun, using makeup, and using soaps that irritate one’s skin. Melasma on the face can be distressful.