What is it?

Melasma is a discoloration of the skin, characterized by tan or reddish patches of irregular pigmentation found on the cheeks, forehead, upper lip and the bridge of the nose, typically on both sides of the face. Sometimes it can affect the neck as well. When it occurs during pregnancy, it is commonly called "chloasma", or mask of pregnancy.

How do you get it?

Although it commonly occurs for no good reason, melasma may occur due to pregnancy, birth control, certain medications, sun exposure, genetics, and rarely, pituitary disorders. For this reason, a dermatologist should evaluate melasma patients. And although anyone can suffer from this skin condition, according to the American Academy of Dermatology, only 10% of people who have this condition are males.

Exposure to ultraviolet light (UV) is a primary contributor to melasma. UV light, most especially from the sun, stimulates the production of melanocytes in the skin. Melanocytes are the cells that give the skin color, and an over-production of these type of cells can result in patches of darkened, or hyperpigmented, skin. Because people with darker skin tones naturally have more active melanocytes, melasma occurs more frequently in women with darker skin tones. However, anyone can be susceptible to this condition, even very fair skin tones, and precautions should be taken before any sun exposure. Additionally, the condition will worsen or reoccur if exposure to UV light isn't mediated by wearing sunscreen or avoiding sun exposure entirely. In particular, when using medications designed to treat hyperpigmentation, or taking oral contraceptives, it's crucial to use a sunscreen that blocks both UVA and UVB rays, with at least an SPF 30, on a daily basis.

Treatment

First and foremost, treatment should be targeted at prevention. Even slight skin irritations or abrasions can cause Melasma to worsen, so adopt a gentle skin regimen, designed for sensitive skin and watch for signs of irritation after using cleansers, makeup or skin creams.

Before attempting any treatment of melasma, consult with a doctor or dermatologist. On rare occasions, melasma may be the result of a more serious problem and a doctor will be able to diagnosis the situation accurately and safely. Once the hyperpigmentation has been linked to melasma, the doctor will also be able to recommend a suitable treatment plan. If the melasma is due to a medications such as birth control or acne treatments, the doctor will determine whether discontinuing or change medications is warranted. To address the darkened patches of skin, lightening or fading creams and gels are good starting points. Rather than bleaching the skin, these products suppress melanocyte production in the skin, effectively stopping hyperpigmentation. Hydroquinone is one of the most common ingredients used to treat melasma, and can be purchased in a 2% solution over-the-counter. For more aggressive lightening, a doctor can prescribe up to a 4% solution. Other ingredients that are sometimes helpful in treating melasma are glycolic acid, licorice, urva ursi and kojic acid, which are safe for use by anyone sensitive to hydroquinone. Finally, results may take several months. Lightening products will need to be used on a daily basis and all sun exposure should be severely limited while trying to fade any marks of melasma.

Product Picks

MaMa Lotion, which contains a combination of two alpha hydroxy acids: mandelic (10%) malic (10%), is a potent skin lightener which gently protects and moisturizes the skin while evening out skin tone. When choosing a sunscreen, look for ingredients like zinc oxide or titanium oxide; physical blocks that prevent UV rays from penetrating the skin. Try: Obagi Healthy Skin Protector SPF 35, which contains 9% micronized zinc oxide to effectively shield delicate skin from UV damage.

Finally, to help even out skin tone, choose a non-irritating concealer such as Dermablend Cover Crème. This full-coverage foundation is extremely light, yet effectively covers up uneven pigment and flaws without causing further irritation.

Special considerations

Some people have achieved positive results from procedures like microdermabrasion, laser surgery or chemical peels, but these can also cause irritation that worsens the condition, so proceed carefully if you decide to explore these options.