The Causes of Melasma – What Causes Dark Spots & Pigmentation on the Skin?

Melasma is known as one of the most prominent skin problems in the world, with nearly 6 million Americans suffering from this condition. Melasma often reveals itself in the formation of dark pigmented spots on the skin, appearing on places such as the nose, cheeks, forehead, upper lip and chin. However, these dark spots can also be found in other areas on the body that often get exposed to the harsh rays of the sun. Other common areas where Melasma can form include both the neck and the forearms.

Cases of Melasma can often affect a wide array of people, but women are prone to have higher chances of experiencing Melasma than men. This skin disorder is most prominent during pregnancy and commonly referred to as the “pregnancy mask.” The hormones released during pregnancy are considered one of the main reasons behind the formation of Melasma in pregnant women. Melasma is also common in those who have darker skin tones like those who are North African, African-American, Middle Eastern, Latin or Hispanic descent. With that said, this skin condition can also be related to genetics.

Women who are sensitive to hormonal changes and are taking birth control or changing the brand of birth control pills can provoke Melasma to develop.

The most common signs of Melasma are the formation of brown or gray spots that become present on the face. Although less common, but still possible, dark spots on both the forearms and neck can also begin to form. Melasma is not known to cause any other reactions, with the only common complaint regarding how it appears on the skin.

In terms of the significant cause of Melasma, it’s still unknown. Experts believe that the cells that produce pigment in the skin begin to overproduce, resulting in the appearance of dark spots on the skin. Those with deeper/darker skin tones are subject to Melasma due to their melanocytes (color-producing cells) being more active than those who have lighter skin tones. However, those who have Melasma and have a darker complexion may not find the condition to be so bad due to the surrounding skin making it harder to notice the formation of it.

The Causes of Melasma

The question remains, what causes dark spots to form on the skin? To this day, researchers have still not identified a distinct cause related to how Melasma develops. However, most experts have concluded that pregnancy, hormone replacement therapy, family history, birth control, anti-seizure meds, and sun exposure can all trigger the development of Melasma.

As evidence suggests, sun exposure is also believed to cause dark spots, with Melasma peaks rising during the warm summer months of the year and sun exposure at it’s highest. During the winter, studies have proven that patients with Melasma reported a decrease in the appearance of their dark spots.

Melasma during pregnancy is known medically as Chloasma but commonly referred to as the “pregnancy mask,” as mentioned previously. During the final two stages of pregnancy, mothers face an increased amount of hormones such as estrogen, melanocyte-stimulating hormones, and progesterone. Researchers believe the “pregnancy mask” is related to the boost in progesterone and not so much the melanocyte-stimulating hormones. Also, menopausal women who take hormone replacement treatments with progesterone have been prone to developing Melasma, while those who took estrogen were less likely to have the appearance of dark spots on their skin.

Common Melasma Causes

The most common causes of the dark pigmented spots due to Melasma include sun exposure, hormonal changes such as pregnancy and hormone treatments like birth control or HRT (hormone replacement therapy).

Exposure to the sun is also widespread among those who suffer from Melasma. Asian women who are pregnant or women who are of Latin descent are especially prone to conditions of Melasma. While men sit at the low-end of the spectrum at 10% who develop this condition, more than 90% of women experience cases of Melasma. The best defense against Melasma is by using a high SPF sunscreen to protect your skin from tanning and darkening.

Here are some additional causes of Melasma:

• Hypersensitive melanocytes – Those with hypersensitive melanocytes and experience constant irritation to the skin, can trigger the stimulation and production of excess melanin. Some cosmetics can also trigger the onset of this condition. Irritating makeup or lotion can make the situation worsen over time.
• Cosmetic products – As mentioned above, irritating cosmetics can increase the formation of color-producing cells that create dark spots on the skin. Those who have a family history of Melasma should use caution when it comes to the products they use on their skin.

If you believe that you are susceptible to Melasma, be sure to talk with your medical provider before proceeding to take birth control or hormone tablets.

The Signs of Melasma

Melasma often appears in three distinct patterns on the face.

Melasma can appear on the center of the face and is referred to as Centro-facial. This occurrence happens when the formation of dark spots form on areas such as the chin, upper lip, forehead, cheeks, and nose.

• The malar pattern is related to Melasma and forms on the upper areas of the cheeks.
• Mandibular pattern refers to dark spots and forms around the jaw region of the face.
• Melasma may also be visible on other parts of the body including the upper sides of the neck and the forearms.

How to Treat Cases of Melasma

The best way to treat Melasma is by practicing methods of prevention. An example of this would include using a high SPF sunscreen to protect your skin from the sun. Experts recommend applying sunscreen daily to maximize protection. If you notice that the sun exposure is extreme on a specific day, it’s recommended to use sunscreen every 2 hours to prevent Melasma.

However, in some cases, sunscreen may not entirely protect you against severe sun damage. Be sure to visit a skincare specialist to discuss other preventive measures or stronger treatments that will help you remove your Melasma condition.

How to Treat Cases of Melasma With Medication / Topicals

When it comes to treating Melasma, there are several options. For instance, creams that contain hydroquinone such as Admire My Skin or Divine Derriere can be used to tackle the different forms of discoloration on the skin. However, if you require a stronger solution, you can acquire creams that contain 4% hydroquinone through a prescription. Research has found that over-the-counter products are capable of effectively lightening skin discoloration and dark spots related to Melasma. Also, over-the-counter products have proven to be less irritating to the skin if you follow the directions correctly.

A combination of creams and lotions that contain ingredients such as hydroquinone, azelaic acid, a phenolic hypopigmentation agent, and retinoic acids are used to treat Melasma. In severe cases, doctors may prescribe higher doses of hydroquinone with a form of acid to reduce the appearance of Melasma. These acids include azelaic, retinoic, tazarotene, adapalene, kojic, lactic, and glycolic.

It’s not uncommon for Melasma to clear away naturally without any form of treatment. Many patients have reported a decrease in the visibility of spots after avoiding direct sunlight. Others, who have hormonal Melasma, claim that their symptoms reduced after giving birth or after they stopped taking hormone therapy.

A temporary and common side effect of Melasma medication is skin irritation. Those who may require long-term hydroquinone treatments have an increased risk of ochronosis, which is known as a permanent discoloration of the skin. Ochronosis is rare in the U.S. and is more prominent in countries where doctors will prescribe higher concentrations of hydroquinone to their patients.

In countries such as Africa, doctors may prescribe different strengths of hydroquinones, with some going as high as 20 percent (which is far beyond the max dosage in many countries.) Hydroquinone medications should immediately be discontinued if you suspect that you are developing symptoms of ochronosis.

How to Treat Melasma With Medical Treatments

Melasma can be treated with medical treatments, chemical peels, laser treatments, and microdermabrasion. These are just a few options to consider to remove Melasma effectively.

Chemical Peels to treat Melasma

Chemical peels can be performed at a dermatologist office or skincare boutique. From there, a technician will evaluate your condition and recommend a set of treatments that will be tailored to your specific type of Melasma. Various combinations of both HQ creams and glycolic acid peels are also used to treat forms of Melasma.

Microdermabrasion to treat Melasma

Vacuum suction, aluminum crystals, and diamond chips can also be used to reduce Melasma during a microdermabrasion treatment. The suction pressure can be adjusted to fit your skin type.

On average, microdermabrasion treatments can last anywhere from five minutes to an hour and do not require any recovery time after being performed. However, to see visible results, several microdermabrasion treatments will be necessary. Remember to apply sunscreen daily for best results. Also, microdermabrasion treatments are considered cosmetic and will not be covered by insurance.

Lasers to treat Melasma

Laser treatments can also be used to treat forms of Melasma. It’s recommended that these procedures are used with caution, as sometimes they can intensify dark spots on the skin if done incorrectly. Multiple treatments are often required to see visible results. Like any Melasma treatment, it’s best to continue a daily sunscreen regimen to ensure you achieve the best results.

The Most Effective Way to Treat Melasma

By far, the most effective way to treat Melasma is through a combination of laser treatments and skin lightening topical creams that contain active skin lightening ingredients.

There are a few different types of lasers that work to reduce Melasma. A specialist may combine different types of lasers in your treatment to effectively treat your skin correctly.

Research indicates that those who effectively treated their Melasma feel better about themselves and their new appearance. Before considering to experiment with any over-the-counter products, be sure to consult with a skin care professional before proceeding. Nursing or pregnant women should especially be cautious of potent Melasma treatments.