Melasma & Uneven Color

In patients who experience melasma, the skin of their face is prone to brown spots and uneven pigmentation. Melasma is also known as the “mask of pregnancy.”


Melasma causes

Melasma causes are believed to include:

  1. Hormones including estrogen and fluctuations in hormone levels
  2. Genetics
  3. Sun Exposure
  4. Inflammation or irritation
  5. Heat (for example cooks seem to be more prone to developing melasma, though it may be related to #4).

Melasma may worsen with birth control pills, exogenous estrogens, pregnancy, estrogen replacement therapy, and even plant estrogens in your diet.

Although estrogen has long been felt to be central to the cause of melasma, there are few studies to prove this. One can speculate, and since we do not have the research to back this up, the higher levels of estrogen and progesterone during pregnancy and oral contraceptives do indeed play a role in melasma.

Melasma prevention tip: If you do not pay attention to the sun protection, you can treat melasma all you like and it will simply recur.


Melasma treatment: Is there a cure for melasma?

Unfortunately, there is no known permanent cure for melasma. Melasma is a common disorder caused by increased pigmentation of the skin, usually on the exposed areas of the face. It is more common in women with darker skin tones, and women who are pregnant, on birth control pills, or taking hormone replacement.

Sun avoidance/sun protection and sunscreen use, daily is probably the most important intervention you could do for melasma.

A broad spectrum sunscreen with titanium dioxide, zinc oxide or avobenzone is suggested.

Treatments or interventions that can help reduce melasma include: hydroquinone (e.g. Eldoquin), a series of light chemical peels, azelaic acid, IPL, and the Dual Fraxel laser avialable in all CosmeSurge Centers. Special peels containing skin lightening agents other than hydroquinone such as kojic acid and vitamin C are available at all our Centers as well.

 At CosmeSurge® we have all of the above mentioned modalities and patients do get better for months and sometimes years depending on how committed they are to avoiding sun exposure. Sun exposure does not have to be long to stimulate recurrence of the pigmentation. Five minutes here and five minutes there add up in the form of an accumulated dose of radiation.

Here is Dr Max’s advice for you: Do not get depressed or frustrated. Just accept that treatments are successful when done at our Centers but be prepared to get another treatment sometime down the road. It is like saying “If my house is going to get dirty again, why should I ever clean it in the first place?


Melasma treatment tip:

When considering melasma treatment, care and consideration must be used for patients with darker skin types, as hypo-pigmentation may occur, creating a separate skin problem. Dermatologist have always warned you to avoid exposure to sun especially between 11 AM to 3 PM. But that is the most important time to get the 10-20 minutes of exposure to build vitamin D, a hormone essential in fighting cancers, osteoporosis and depression. What to do? Cover your head and expose your body. Read more in Dr Max’s wellness section.