Melasma 101

What causes melasma and how to treat it

5 minute read

We’re here to tell you what we know, but don’t take it as medical advice. Talk to your medical provider about your specific health concerns.

With a nickname like “the mask of pregnancy,” melasma is clearly a common skin concern among women—in fact, only 10% of people who get melasma are men! But there’s more to melasma than just gender and pregnancy. Sun exposure and other hormonal changes can trigger melasma too, especially in people with melanin-rich skin (darker skin tones) and those with a blood relative who also has melasma. Appearing as flat brown or brown-ish gray spots and patches on the face, it’s not harmful or painful, but we definitely understand that “get it off my face!” feeling. So let’s break it down from Curology medical providers’ POV and explore options that may help treat or prevent melasma.

What is melasma? 

Melasma is a form of hyperpigmentation (excess pigment). It occurs primarily in women and can often be harder to treat than other forms of hyperpigmentation. 

Melasma shows up as  flat patches of skin discoloration, usually on the cheeks, bridge of the nose, forehead, chin, and above the upper lip. Patches can also appear on parts of the body that get a lot of sun exposure, such as the forearms and neck, but this is less common than facial melasma. 

There aren’t any symptoms of melasma that you can feel (i.e., burning, pain, or dryness); it’s a cosmetic concern more than anything. Of course, that doesn’t make it any less important, especially if you don’t like how it makes your skin look! So let’s get into the causes, preventative tips, and treatment options for melasma.

What causes melasma?

Sun exposure: One of the biggest risk factors for melasma, UV light from the sun stimulates melanocytes to produce more melanin (the darkening pigment in the skin). In fact, just a small amount of sun exposure can make melasma return after it’s faded, which is the main reason why many people with melasma get it again and again!

Pregnancy: The increased levels of estrogen and progesterone (among other factors) that occur during pregnancy are thought to be a common culprit.  

Hormone treatments: The use of hormonal birth control or hormone replacement therapy can also trigger melasma.

Genetic influences: For some of us, a tendency toward melasma is a matter of the luck of the draw, genetically speaking. Wearing sunscreen every day can help keep melasma in check though!

Melasma during pregnancy, aka the “pregnancy mask”

The hormonal changes that happen when you’re pregnant can lead to darkening of certain areas of your skin that have more pigmentation to begin with such as the areolae and nipples, genital skin, underarms, and inner thighs. The vertical line at the center of the abdomen called the linea alba—a pale line that runs through your belly button, which is so subtle that it usually goes unnoticed—can also darken during pregnancy. When that line darkens between your belly button and your pelvis, it’s called linea nigra (black line). These changes are almost always temporary! Areas of your skin that darkened during pregnancy usually fade gradually after delivery.

Melasma, which often appears as symmetrical dark spots and patches on the face, is another common skin change that pregnant women experience. It’s so common, in fact, that it’s been charmingly nicknamed the “pregnancy mask” or “mask of pregnancy.” If that sounds scary, don’t worry—melasma often improves or fades away after delivery (although this is not always the case!). In the meantime, there are ways to treat it.

Melasma treatment recommendations

How to get rid of melasma? When treating melasma, it’s important to have realistic expectations. You may be able to fade melasma, but it won’t happen overnight—and it can come back. We say don’t sweat it, though! Just like beauty marks, moles, and freckles, melasma can be a part of some peoples’ skin journey, and that doesn’t diminish their glow or beauty, not even one tiny bit.

With that said, one of the most important things to do is to wear sunscreen every day. (You know you should be doing that anyway!) The next best thing is to use skincare products with ingredients to help fade hyperpigmentation, like topical retinoids or azelaic acid. 

There are several options available that may help improve the appearance of melasma—but if you’re pregnant, breastfeeding, or trying to conceive, not all of these are known to be safe for the baby! Read on to the next section for treatment options specifically for you.

Treatments for melasma may include:

• Sun protection (SPF 30 or higher is recommended)

• Topical medications

• Tretinoin

• Azelaic acid

• Tranexamic acid

• Hydroquinone 

• Kojic acid

• Heliocare 

• In-office procedures like lasers, light therapy, and chemical peels

How to treat melasma during pregnancy and breastfeeding

If you have melasma while pregnant or breastfeeding, take care to use products that are known to be safe. Vitamin C serums and products with azelaic acid are generally considered safe to use during pregnancy. As always, be sure to double-check with your OB-GYN before starting a new product.

Vitamin C serums

Vitamin C masks and facial treatments

How Curology can help

For a custom treatment that can help with hyperpigmentation, signs of aging, and/or acne, you’ve definitely come to the right corner of the internet. Curology offers all of the above, delivered to your door—plus, access to a medical provider specialized in all things skincare. Sign up for a free trial now to get your very first custom cream for a simple-but-super solution to whatever skin issues your face is facing.

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