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 Knowledge drop: In your 20s, your skin cell turnover decreases. (Cell turnover is a key component in keeping your skin youthful.) You know what else slows down? Your collagen production. Starting in your 20s, collagen decreases by about 1 percent per year. Should you want to prevent fine lines and wrinkles, start by eliminating behaviors that contribute to premature aging. “If it’s bad for you, it’s bad for your skin,” says dermatologist Michel Somenek. “Cigarette smoking reduces blood flow to the skin and causes premature wrinkling and a dull skin texture. Making the repeated pursed motion to inhale can also cause smoker’s lines. Alcohol and recreational drugs are toxins for the skin that damage its cellular structure and DNA,” Somenek tells us. “The faster you eliminate vices while you are young, the better chance your skin and body have to recuperate.” Also, adopting an anti-aging routine in your 20s is key. After all, the best offense is a good defense. We spoke to Somenek and experts Joshua Ross and Audrey Kunin to find out more. Keep reading for the best anti-aging products for your 20s, according to skincare professionals. Sunscreen “We all know that the sun is the number one cause of skin aging and starting the prevention in your 20s is very important,” Ross says. “The majority of your sun damage won’t start to appear until you’re in your 30s, so don’t wait until you see it surface or you’ll be behind the curve. Stay ahead of it with a good-quality zinc-based sunscreen worn daily.” Farmacy Green Defense Daily Mineral Sunscreen An invisible sunscreen with SPF 30, plus botanical extracts meant to protect skin with tons of antioxidants. Bonus: It’s clean and fine to use under makeup. Bareminerals Complexion Rescue™ Tinted Moisturizer Broad Spectrum SPF 30 Although we recommend you use your SPF and moisturizer separately, we also understand moments when you don’t have time or energy for that extra step. For those times, this bareMinerals moisturizer is a great thing to have on hand. Vitamin C Serum “A great introduction to anti-aging is to start with a vitamin C serum in your morning skincare routine,” Ross says. “It’s a powerful antioxidant that will neutralize free radicals and brighten the skin.” He adds that it’s a great way to counteract the effects of the sun’s harmful rays, which, as previously mentioned, are among the biggest causes of premature aging. Drunk Elephant C-Firma™ Vitamin C Day Serum The Drunk Elephant C-Firma is a lightweight serum that promises to give skin a glow by combining the brightening powers of vitamin C with ferulic acid, l-ascorbic acid, and vitamin E. The included sodium hyaluronate is meant to replace hydration loss, so you shouldn’t have to deal with any irritation. Sunday Riley C.E.O. Rapid Flash Brightening Serum This potent serum is jam-packed with vitamin C (15 percent, to be exact), which means it’s a potential superstar at both brightening skin and dousing it in antioxidants. Peptides Using peptides on your skin has many benefits, says Somenek. “The skin barrier is what defends the body against pollution, UV rays, bacteria, and toxins. It can be damaged by several everyday factors. Using topical peptides aids in building a stronger barrier,” he says. “Peptides comprise elastic fibers, which are a type of protein. These fibers help to make skin appear taut and firm. Peptides can also help repair damaged skin, relieve inflammation, and even out skin tone. Some peptides can kill acne-causing bacteria that is common in 20-somethings.” Kunin agrees, saying, “Peptides are an excellent entry point for supporting collagen.” She recommends looking for face and eye treatments that contain these collagen-boosting powerhouses. Charlotte Tilbury Magic Eye Rescue Cream This Charlotte Tilbury super-emollient eye cream has a base of coconut oil and shea butter (read: it’s incredibly hydrating). Botanicals plus peptides are meant to help reduce dark circles and boost collagen, respectively. This creamy moisturizer serves up potent collagen-boosting peptides and pycnogenol, and antioxidant-rich vitamin C. “Instead of sitting on top of the skin, peptides penetrate the outer layer so they go deep. The ‘signals’ they send tell the cells to produce elastin and collagen, which are needed for youthful-looking skin,” explains Somenek. At-Home Peel Pads Remember that skin cell turnover fiasco we talked about earlier? One way to help support it is by exfoliating. “Exfoliation is important to help keep skin fresh and luminous,” Kunin says. She recommends using at-home peel pads as an easy and effective way to exfoliate. “The goal in your 20s is to fight the slowing pace of cell turnover. It is wise to use products that gently exfoliate, yet still remove oil and other impurities. Products that have Alpha Hydroxy Acids (AHA) or Beta Hydroxy Acids (BHA) are a good choice.” According to Somenek, you should only exfoliate two to three times a week. “People of all ages are guilty of over-exfoliating and that can be too much of a good thing,” he says. Dermadoctor Kakadu C Intensive Vitamin C Peel Pad A few swipes of this Derma Doctor powerful peel pad promise to leave your skin glowing and smooth, thanks to the seven (yes, seven) types of chemical exfoliants, including AHA and BHA. It also contains vitamin C via Kakadu plum extract for added brightening and antioxidant protection. KEY INGREDIENTS Kakadu plum extract is sourced from the Kakadu plum, a fruit grown in northern Australia. It contains vitamin C, which restores the skin’s natural barrier, increases collagen production, and soothes irritation. Dr. Dennis Gross Skincare Alpha Beta® Universal Daily Peel Pads These are the gold standard of peel pads, with a cult following and over 900 five-star reviews on Sephora. They’re easy to use and contain a blend of anti-aging exfoliating acids. Emollient Night Cream “In your 20s, you need to start upping the hydration in your skincare routine. You may have been cautious of over-moisturizing because of acne in your teens, but as you enter your 20s, your skin transitions and becomes drier,” Ross says. “I recommend an emollient night cream added into your evening skincare regimen.” “Twenty-somethings need to make sure that they are not using creams that will clog their pores and cause excess oil production,” says Somenek. Opt for non-comedogenic products. Cerave Skin Renewing Night Cream One great choice is the CeraVe Skin Renewing Night Cream, which is a non-comedogenic night cream that leaves skin soft and glowy. It combines the moisturizing powers of ceramides and hyaluronic acid. RoC Retinol Correxion Max Hydration Creme “The best night cream ingredients contain retinol, benzoyl peroxide, and/or salicylic acid or hyaluronic acid. The goal is to moisturize, yet remove excess oil,” says Somenek. This Roc Retinol Correxion cream fits the bill as it contains both hyaluronic acid and retinol so it promises to moisturize while also being non-comedogenic.

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