What is Melasma?

What is Melasma?

Melasma, also called chloasma, is a skin condition with darks spots on the face, upper lip and mustache area. It is caused by an excess of the skin pigment melanin that appears on the cheeks, forehead, chest, back, and upper lip. This frustrating skin condition can be seen in men and women. It is usually caused by sun exposure, heat, and hormones. It is so common in pregnancy that it is often called the “mask of pregnancy”.

Melasma on the face is stubborn and often won’t go away without a targeted skin care routine with skin lightening ingredients.

How to Diagnose Melasma

The definition of melasma is dark spots in sun exposed areas in people with a history of sun exposure, estrogen use, pregnancy, or heat exposure and no history of inflammation in the affected area.

You do not need a skin biopsy to diagnose melasma. It is usually diagnosed by history, location of the dark spots, hormone status (such as pregnancy or on estrogen or oral contraceptives), and by the color of the patches.

Melasma patches can be a grey/brown color but can be very dark in darker skin types.

Melasma can also occur in men but is less common. Melasma is almost always associated with increased estrogen levels. In men, a dark patch on the face is more likely to be PIH.

Types of Melasma

Melasma is a hyperpigmentation condition of uneven skin tone that occurs in sun exposed areas. When it happens in pregnancy, it is often called chloasma or “mask of pregnancy”.

There are the different types of melasma:

Brachial: This type of melasma occurs on your upper arms and shoulders.

Centrofacial: With centrofacial melasma, brown spots appear on your cheeks, forehead, nose and upper lip.

Lateral cheek pattern: Doctors diagnose you with lateral cheek pattern melasma if it appears on both cheeks.

Malar: Malar melasma is when the spots appear on your nose and cheeks.

Mandibular: The melasma occurs around your jawline with mandibular melasma.

Neck: This melasma type occurs on any side of the neck.

Melasma mustache iamge

Melasma Mustache

A “melasma mustache” refers to the hyperpigmented patches that appear on the upper lip region, mimicking the appearance of a mustache. This form of melasma is very common. Any time I see a dark patch above the lip I immediately think it is melasma but it is important to remember that other causes of hyperpigmentation of the upper lip are possible.

Inflammation leads to hyperpigmentation in a disorder called post-inflammatory hyperpigmentation or PIH. This means that any condition that causes inflammation on the upper lip can be misdiagnosed as a melasma mustache.

When you have dark patches on the upper lip, rule out the following:

Perioral dermatitis- a facial rash that tends cause a red ring that surrounds the mouth and can turn dark.

Lip licking dermatitis

Eczema around the mouth

A substance on lip causing sun sensitivity such as an aftershave, cologne or perfume.

What causes melasma

Melasma Causes

Melasma or chloasma occurs when the cells that make pigment in your skin, called melanocytes, increase the production of melanin pigment. There are many reasons this can happen but the most common causes of melasma are:

Sun exposure

Heat

Inflammation

Injury resulting in inflammation

Estrogen

There are lots of studies looking at why these cause melasma, but the focus of research is on what turns the melanocyte on and makes it make more pigment?

These are the causes of the increased pigment production seen in melasma:

Ultraviolet light stimulation of the protective tanning response

Infrared heat

Increase of melanocyte stimulating hormone

Stimulation of the transcription factor p53 in the keratinocyte (epidermal skin cell)

Melasma and the Microbiome

Recent studies (14) have linked gut microbiota imbalances to various skin diseases, including psoriasis, atopic dermatitis, and acne. This imbalance can influence estrogen metabolism, with gut bacteria-produced β-glucuronidase enhancing estrogen reabsorption. Since melasma’s development is tied to abnormal estrogen metabolism, understanding the gut-microbiota relationship is crucial. In a study comparing melasma patients to healthy subjects, 16S rRNA sequencing revealed significant differences in the abundance of certain bacteria, notably Collinsella spp., Actinomyces spp., Parabacteroides spp., and others. Many of these bacteria are associated with β-glucuronidase production and estrogen regulation. Alterations in gut microbiota, particularly the presence of Collinsella spp., may influence melasma development by impacting estrogen metabolism. This research offers insights for future melasma studies and potential treatment avenues.

Melasma in Dark Skin

Melasma in dark skin is harder to treat. One reason is that dark skin types have more melanin granules in the skin and they are harder to get rid of because there are more.

The other reason it is harder to clear melasma in dark brown or black skin is skin lightening treatments can cause a halo affect around the treated dark spot. This halo is a light colored ring surrounding the dark melasma spot.

Read here about how to treat dark spots in black skin.

Why Is Melasma Hard To Treat?

Melasma is hard to treat because it is caused by things we cannot avoid: such as light, sun, heat, stress and hormones. Our face is exposed to these on a daily basis.

There is no cure for melasma, but it can be controlled by changing your lifestyle habits and using the correct melasma skincare routine consistently.

Treatments for melasma on the chest

Melasma on the chest

Melasma can occur in any sun exposed are such as the chest. However, it is more likely that dark spots on your chest are caused by phytophotodermatitis or fragrances and cologne that make you sun sensitive.

Look at the pattern o the dark spots on your chest. Do they look like fingerprints? Or are they in an aerosolized pattern like cologne would cause? If so, this may be due to a substance that increased the skin’s ability to tan upon sun exposure such as foods like celery, limes, or figs or perfumes or colognes.

How to treat melasma on your back

Melasma on the back

Melasma is uncommon on the back unless you get a large amount of sun exposure on your back.

If your back is itchy, the dark spots on your back may not be melasma.

Notalgia paresthetica (NP) is a sensory neuropathic syndrome of the back, typically the upper to mid-thoracic region, characterized by localized pruritus (itching) in the affected area. This chronic condition can result from nerve impingement or damage to the posterior rami of the spinal nerves. The itching sensation is described as a burning or prickly itch that is difficult to reach and relieve. Chronic scratching or rubbing of the area in an attempt to alleviate this itch can lead to post-inflammatory hyperpigmentation which resembles melasma. If you have notalgia paresthetica, using soothing anti-inflammatory ingredients and barrier repair moisturizers and oral antihistamines to relive the itch are more important than using skin lighteners to lighten the dark spots on the back.

Melasma and self esteem

Many studies have shown that melasma is stressful and can affect self esteem.

Let us help you treat your hyperpigmentation and build the best skin lightening care routine for your Baumann Skin Type.

DQH Can I use salicylic acid first and then vitamin C? It’s easy to create a skincare routine, but knowing how to use it is another thing entirely. In most cases, if you’re not getting the desired skin results, it could be due to the layering of conflicting ingredients. So, is it possible that salicylic acid and vitamin C are such ingredients? Or are these active ingredients the duo that’s been missing from your skincare routine? If you want answers, stick around because today we are going to explain the benefits of salicylic acid and vitamin C and how they can be used in your daily life. What are the benefits of salicylic acid for skin? Salicylic acid is one of the most commonly used beta hydroxy acids and is favored by many people with oily, acne-prone skin. This acid is derived from willow bark, and unlike its water-soluble relatives (called alpha-hydroxy acids), salicylic acid is oil-soluble, which means it can penetrate deeper into the lower layers of the skin. Once it reaches the lower layers, it can help unclog pores of excess sebum, dirt, bacteria, debris, and impurities. This results in clearer skin tones and greater definition. Not only does salicylic acid benefit the underlying layers, but the outer surface of the skin benefits as well. When applied to the skin, salicylic acid removes the buildup of dead skin cells. This is accomplished by breaking the bonds that hold dead cells to the surface. Over time, this can cause the complexion to look dull and prone to acne, blackheads, and other blemishes. If you’d like to learn more about salicylic acid and how it can improve your skin, check out this dedicated blog post from a beauty insider. What are the benefits of vitamin C for skin? Vitamin C is considered one of the most powerful antioxidants, which means it is very effective at fighting free radicals and preventing them from causing further skin damage. Examples of free radicals include pollution, central heating, UV rays and harsh climate. They attack proteins, fats and cell membranes as soon as they come into contact with the skin, causing signs of premature aging such as fine lines and wrinkles as well as hyperpigmentation, flaky patches of skin and loss of elasticity. Many people usually prefer to use vitamin C in their morning routine as this ingredient gives the complexion a radiant glow. You’ll also find that vitamin C can target areas of hyperpigmentation, plumping the skin and reducing the appearance of fine lines and wrinkles. The thing about vitamin C is that there are a lot of outdated studies going back to the 1950s that describe vitamin C as an unstable skin component. Thanks to improvements in modern technology, this is no longer the case as all products now contain a stable form of vitamin C. Visit The Beauty Insider to learn more about vitamin C. So please check out our blog post. Can I use salicylic acid first and then vitamin C? Yes, you absolutely can. In fact, it’s thought that using salicylic acid before using vitamin C ensures it penetrates faster and works faster. This is an efficient way to utilize two power sources, and the reason has to do with pH. For example, the skin’s natural pH is about 4.7, making it slightly acidic. Salicylic acid and vitamin C are also both acidic, and you’ll find that vitamin C is absorbed quickly into the skin. Therefore, using salicylic acid beforehand can increase the acidity of the skin and allow vitamin C to penetrate into the skin faster. While this is considered an effective way to combine two powerful ingredients, you need to be aware of your skin type and how it reacts to certain active ingredients. Even people with perfect, normal skin can experience skin sensitivity and irritation. Therefore, always consult a doctor or dermatologist before using any new products on your skin. It’s also important to follow skin application rules. In this case, you need to use the product correctly to ensure you get the best results for your skin. If you’re not sure what I mean, the basic rule for skin is to start with the thinnest consistency and work your way up to the thickest consistency. This prevents a barrier from forming on the surface, preventing other active ingredients from penetrating the skin. Can I use salicylic acid at night and vitamin C in the morning? Yes, absolutely, this is considered the most effective way to get returns without any adverse side effects. This is because there is enough time between applications to ensure that the skin’s pH levels return to balance. You’ll also find that Vitamin C is rich in antioxidants and is perfect for use in the morning to ensure your skin is protected and looking its healthiest. Due to the small size of salicylic acid molecules, it is an acid that is able to reach the deepest parts of the skin. While this is effective at keeping skin clear, it also increases the risk of irritation and photosensitivity. Therefore, many people prefer to use powerful BHAs in their evening routine without exposure to UV rays, pollution, or harsh weather. Warning: If you avoid using sunscreen every day, none of these ingredients will do what your skin needs. The combination of chemical peels and powerful ingredients increases the risk of further damage to the skin’s surface. Use SPF 50 every day to keep your skin protected and your lipid barrier healthy, even on cloudy days, keeping your skin in top condition.

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