Six Things To Know If You Have Melasma

Lately I’m seeing more and more clients struggling with Melasma, a skin condition that causes patches and spots, usually on the face, which are darker than your natural skin tone. It can be very frustrating because like a lot of other skin conditions there is a lot of misinformation and mixed messages out there.  Seeking treatment options leads to overwhelm and I’m encountering more and more people who  just don’t know where to turn. Melasma is a complex subject and it can vary from person to person. 

First, what is it?

The discolored patches of Melasma can be tan, brown, grayish brown or bluish gray or freckle-like spots. They usually appear in certain areas like the cheeks, forehead or chin and above the upper lip. It is more likely to appear on areas of the body that are exposed to the sun. Women of reproductive age are most commonly affected, but Melasma can occur at any age.

Melasma occurs when the pigment producing cells in the skin produce too much pigment. There is an underlying hormone responsible for triggering the pigment cells, the melanocyte stimulating hormone. People with darker skin are more prone to melasma because they have more active pigment cells than those with lighter skin. However, Melasma can happen to anyone regardless of skin color. 

Just like acne, there is an internal cause of Melasma that must be addressed. While it can be difficult to treat there are things that you can do! Here are six things you must know:

The hormone connection

Far more women than men have melasma. This is because of the connection between estrogen, progesterone and melasma. Melasma is very common during pregnancy and the menopause transition due to sudden hormone fluctuations. Thyroid imbalances, elevated cortisol and insulin resistance are also connected to melasma. It’s important to know that oral contraceptives as well as hormone replacement therapy can result in Melasma.

The gut connection

With hormone imbalances and other health issues, sometimes excess estrogen can get built up in the system and not be eliminated properly. Overgrowth of bad bacteria in the gut can make estrogen even more potent so doing things to improve gut health can help eliminate excess extra potent estrogen. Improving bowel movements can help this process. Getting enough fiber, and consuming probiotic foods are the simplest way to improve your overall gut health. 

The food and blood sugar connection

Keeping the blood sugar stable with more protein and less sugar can keep your thyroid, more in balance as well as your other hormones. Consuming foods that keep your blood sugar stable will prevent insulin resistance. When you eat foods that spike your blood sugar a lot like sugar or refined carbohydrates, your body then becomes resistant to the hormone insulin. This causes further hormone imbalance thus triggering Melasma. (By the way insulin resistance can put you at risk for many other conditions like diabetes, hypertension, heart disease and Polycystic Ovary Syndrome or PCOS)

The stress connection

Stress affects the skin in so many ways. High levels of stress cause high cortisol levels. Your body produces cortisol to help cope with stress whether it be physical, psychological or emotional stress. More cortisol creates an imbalance in estrogen. Elevated estrogen then increases the Melanin producing hormone level, which produces excess pigmentation on the surface of the skin. While you can’t always control the amount of stress you are under, you can find ways to cope with and reduce your stress levels to break this cycle. Things like breath work, listening to music, taking a walk, stretching, and journaling are all free and easy ways to lower your stress.

Topical Treatments

About a thousand articles found online might tell you to use topical skin lighteners like Tretinoin or Hydroquinone for Melasma. Over the years I’ve seen many of my clients go this direction to try to treat their Melasma with very little improvements. 

Since Melasma is caused mostly by an internal issue,these types of treatments have little lasting effects. Tretinoin is often prescribed in very strong concentrations that can cause irritation which can actually trigger Melasma for some people. Hydroquinone is a skin bleach that  has many serious side effects including permanent skin discoloration (ochronosis), rashes, and facial swelling. 

In cases of Melasma the body's built-in stress response makes it want to produce extra pigment as a means to protect you. No topical product can resolve what’s going on internally.  

I do believe that topical regimens designed to protect your skin’s barrier can be helpful in the long run as long as you’re also taking measures to improve what’s going on internally through diet changes and stress reduction. Topical antioxidants like Vitamin C that prevent the formation of damaging free radicals can make your skin function better and be more resilient overall. 

Calming and cooling treatments to the skin can help too since we know that heat and irritating products can exacerbate this condition. 

Prevention

Keeping the skin cool while outdoors (think shade and sun hat in addition to SPF) is a proven way to keep Melasma from becoming more visible. 

Avoiding harsh products or treatments that cause irritation or excess heat will help minimize symptoms of Melasma. Steer clear of chemical peels (peels can trigger the body’s stress response and cause more melasma), microdermabrasion or light treatments that cause heat in the skin. Topical products that over-exfoliate or are abrasive are big triggers also. 

You can get relief from Melasma.. It may take some time to employ some of these tactics and it’s important to give yourself some grace through the process. If you feel overwhelmed or need help getting started, I am here for you!

Disclaimer: This blog provides general information and discussions about skin health and related subjects. The information and other content provided in this blog, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.