Medical Melasma in Stuart and Tequesta, FL

Melasma is a common and frustrating skin condition that affects over five million people in the United States alone. It causes hyperpigmentation, which can present itself as symmetrical, blotchy brown to gray-brown patches on the face and neck. It is also known as chloasma or the mask of pregnancy. Found more commonly in women with darker skins tones, it is especially prevalent in those of Hispanic, Southeast Asian, African, Indian, Mediterranean, and Middle Eastern backgrounds. Additionally, people living in areas of intense ultraviolet light are at higher risk for melasma. Although this condition is not harmful, it is often a challenge to treat and can have a negative effect on one’s quality of life. Because of these detrimental social and psychological effects, it is important to seek proper treatment. Visit Spyglass Dermatology in Stuart and Tequesta, FL, to learn more from Dr. Ryan Alan Schuering or a member of his staff.

Melasma is caused by increased activity of the pigment-producing cells of the skin (melanocytes), resulting in more pigment deposition. The exact cause of melasma is unclear. However, a common inciting factor is exposure to sunlight, which is thought to activate the melanocytes to produce more pigment. Hormones are also thought to play a role, but the exact link between hormones and melasma has not been clarified. Nevertheless, circumstances that affect hormones, like pregnancy, oral contraceptives, and hormone replacement therapy, can contribute to the development of melasma. Genetic factors also seem to play a role, with some studies showing a higher incidence among family members. Less common risk factors include thyroid disorders, phototoxic medications, and cosmetics.

Treatment of melasma often requires the use of multiple types of therapies, with results occurring over the span of several months. Reducing exposure to sunlight and applying sunscreen daily is often a critical step. When outside, avoiding direct sunlight by wearing a wide-brim hat or other protective clothing is more effective than sunscreen alone. Patients should use a high-factor broad-spectrum sunscreen that has good protection against UVA light. Furthermore, sunscreens with protection against visible light may provide additional benefits. These will help to reduce the production of more uneven pigment.

Topical retinoids and glycolic acid peels can be used to increase the elimination of pigment already present. Additionally, topical depigmenting agents like azelaic acid or hydroquinone are useful, often in combination with a retinoid and a topical steroid. Other topical options include kojic acid and niacinamide. Laser therapies work by targeting the pigment in the skin, though the results are mixed. Tranexamic acid can be used topically or orally to prevent activation of the factors that stimulate pigment-producing melanocytes. For women who experience the onset of melasma after starting an oral contraceptive, the medication should be stopped if possible. Pregnancy-induced melasma may improve postpartum without the need for treatment. Effective treatment of melasma often requires a combination of many of these therapies. Each patient is unique and should visit a board-certified dermatologist to determine which therapies are right for them.

Can medical melasma be triggered by hormonal changes?
Yes, hormonal changes are one of the most common triggers for melasma, particularly in women. Fluctuations during pregnancy, the use of birth control pills, and hormone replacement therapy can all increase melanin production, leading to melasma. These hormonal influences are sometimes referred to as "the mask of pregnancy" when melasma appears during pregnancy. Managing hormonal balance and avoiding unnecessary hormonal fluctuations can help prevent the worsening of melasma.

Does melasma tend to worsen with sun exposure?
Sun exposure is a significant factor in the development and worsening of melasma. UV rays stimulate melanocytes, the skin cells that produce pigment, causing the dark patches to become more pronounced. Even short-term exposure to the sun can cause flare-ups, making sunscreen use essential. Broad-spectrum sunscreen with an SPF of 30 or higher, along with physical protection like hats and sunglasses, can help manage melasma.

Is melasma more common in certain skin types?
Yes, melasma is more common in people with darker skin types, such as those of Hispanic, Asian, African, or Mediterranean descent. These individuals have more active melanocytes, which can lead to increased pigmentation when exposed to triggers like the sun or hormonal changes. However, melasma can affect anyone, regardless of their skin type or ethnicity. Those with a family history of melasma may also have a higher likelihood of developing it.

Don't let melasma cause you to feel insecure about your body. At Spyglass Dermatology, our team is dedicated to ensuring each of our patients receives the best possible skincare when it comes to melasma or any other condition. Contact our office in Stuart and Tequesta, FL, today to schedule your consultation with Dr. Schuering and determine the best form of treatment for your melasma.