Every summer, that feeling slowly returns, a subtle darkening of the skin on my forehead and temples that eventually appears like a map of an unknown continent. It’s been ten years since I’ve been pregnant, but my changing skin reminds me every year that no part of my body has been untouched by the experience. I wear the memory of it on my face.
Sometimes called the “mask of pregnancy” because it often appears when a person is pregnant, melasma is “hyperpigmentation or dark discoloration of the skin that can appear anywhere on the face, but often involves patches on the forehead, cheeks, and above the upper lip,” Dr. Susan Massick, a dermatologist at The Ohio State University Wexner Medical Center, told HuffPost.
It’s a good idea to see a dermatologist, Dr. Christine Greves, an ob-gyn at Orlando Health Winnie Palmer Hospital for Women and Babies, told HuffPost. “Sometimes it can be confused with other skin conditions,” Greves explained, adding that a dermatologist can diagnose it “by looking closely at the skin, usually with a specialized device.”
The good news is that, aside from the discoloration, melasma isn’t dangerous and doesn’t cause any other symptoms. You won’t have any pain, discomfort, itching or inflammation, Massick said. However, she added that you may feel “self-conscious about it.”
“The diagnosis is made based on the clinical appearance and the story behind it: what it looks like on your skin and how and when it started,” Massick explained.
Among the world population, the incidence of melasma is approximately 1.5–33%, but it rises to 15–50% in pregnant people.
What causes melasma?
Darker skin spots are caused by an increase in melanin, “which is responsible for the pigmentation of your skin,” Greves said.
“There are a variety of different factors that cause skin to darken, such as hormonal changes (pregnancy, birth control pills containing estrogen), sun exposure, genetics/family history, medications or other systemic diseases like thyroid problems,” Massick said.
Because this disorder is so common during pregnancy and occurs more often in women than men, hormones often seem to be the trigger. Hormone levels increase during pregnancy, leading to “increased blood flow and sebum production,” Greves said. “There are specific estrogen and progesterone receptors on human skin,” she continued.
Greves added that “women with medium to dark skin are at higher risk.”
In my case, melasma developed during my pregnancy and was favored by my olive skin and a generous dose of summer sun (despite daily application of sunscreen).
When should I see a doctor?
Even if you’re pretty sure your skin changes are harmless melasma, “be sure to talk to your doctor to get help not only with treatments, but also to make sure it’s actually melasma and not something else that needs to be treated,” Greves says.
There may be a correlation between thyroid disease, which affects hormone levels, and melasma, “so it’s important to treat any underlying thyroid issues appropriately,” Massick said.
Although there is no correlation between melasma and skin cancer, “there is
“It’s important to see a board-certified dermatologist to help manage any new or changing pigmented lesions on your face,” Massick explained. “There’s a type of melanoma called lentigo malignant melanoma that can appear as an irregular hyperpigmented spot on the face,” she said. So it’s best to have any skin changes checked out by a professional.
What treatments are available?
Since UV rays are a common trigger for melasma, sun protection is usually one of the first things doctors recommend.
“Strict sun protection of the area, such as daily use of sunscreen, is an essential part of treatment,” Massick said.
If your melasma is related to birth control or another medication, changing your prescription may be a treatment option for you.
Over-the-counter topical treatments that may help, Massick said, include vitamin C, retinol and azelaic acid. You can also see a dermatologist who can prescribe other topical treatments such as skin-lightening creams containing hydroquinone, sometimes with kojic acid, and retinoids, Massick said. Tranexamic
Acid may also be an option. It can be prescribed orally or topically.
You can also try chemical peels or laser treatments. Massick cautions that laser treatments “should only be performed by a board-certified dermatologist or plastic surgeon skilled in laser technology, as you can have paradoxical worsening of hyperpigmentation if the wrong laser or settings are used.”
If you’re pregnant, you should “focus solely on sun protection and sun avoidance,” Massick said. “You can take more aggressive measures after delivery and weaning if you’re breastfeeding.”
Does melasma ever go away?
It’s possible that your melasma will go away after giving birth, after switching birth control pills, or after reducing your sun exposure. But it’s not uncommon for melasma to reappear, as it does every year, as it does every season.
Melasma “is considered a chronic condition, which means it can come back,” Greves said. Another change in treatment, pregnancy, or just getting some summer sun (even with sunscreen) can lead to a recurrence.
“There is no cure for melasma. It can easily come back and get worse if left untreated or exposed to the sun or UV rays (including tanning beds),” Massick said. “If it does come back, it will be in the exact same place it was before,” she added.
While it doesn’t threaten your health, melasma can “affect people’s self-image and self-esteem,” Massick said. She added that “there are also cultural implications for certain ethnicities where any type of discoloration, especially on the face, is viewed negatively.”
Massick said she tries to help patients understand that there is no cure and that treatment can take time. “You have to have realistic expectations,” she said. She also explained that melasma can be “more difficult to treat and more persistent on skin of color, especially in Asian, Hispanic and African people.”
Americans.”
In addition to consulting a dermatologist, avoiding sun exposure, using sunscreen, and being patient with treatment, Massick advised avoiding skin-lightening creams that promise incredible results. “If they promise too much, they may not work properly.”
“The results are insufficient, especially with regard to over-the-counter drugs,” she said.
When it comes to topical medications like these creams, “more is not better,” she said. “Overdoing it with products can actually make things worse: The irritation will cause the hyperpigmentation to worsen.”
“Prolonged or excessive use of hydroquinone,” she said, can also sometimes lead to “paradoxical darkening” of the skin.