When it comes to skin conditions, melasma is a stubborn one to shake. Unlike a spot that might disappear from once it came in a week, melasma is around for the long haul. If you’re not familiar with this particular skin bugbear, it’s a condition that causes dark patches to appear – typically on the face – and can be down to a plethora of reasons.
Although melasma is typically associated with pregnancy – up to 50% of women are affected when pregnant according to the British Association of Dermatologists – it’s not the sole reason you can suffer from the skin condition (more on that later). The good news is that if you suffer from melasma, you are not alone.
While the condition lingers like a toxic ex and will never completely vanish, there are an array of treatments out there to help manage melasma and help disguise its tell-tale patches of discolouration.
Here’s the low-down on everything you need to know about melasma…
What is melasma?
Let’s start from the beginning. “Melasma is one of the forms of hyperpigmentation defined as “Dark brown to grey-brown, symmetric patches of pigment on the face,” explains dermatologist, Dr Tiina Meder.
What it looks like can vary depending on your skin tone. But in general, Dr Meder says “melasma appears as a dark spot on the face. These can be large or small, can have regular or irregular form, are mostly symmetrical and differ in colour depending on skin tone and intensity of pigmentation”.
If you’ve dealt with pigmentation before, this might look eerily familiar, however, there is a difference between melasma and pigmentation. “All melasma cases could be called “dyspigmentation” but not all dyspigmentation (or pigmentation as it's called traditionally) are melasma. Melasma is one of the most common types of (dys)pigmentation,” explains Dr Meder.
What causes melasma?
You’ve probably heard it dubbed “the pregnancy mask”, but melasma can occur for a range of reasons.
To put it simply, “any factors able to stimulate the synthesis of melanin in the human skin could cause melasma,” explains Dr Meder. She breaks down the other key factors in the melasma-causing game:
Melanin synthesis: This is a complex process happening in the skin, but it is influenced by the nervous system and directed by hormones.
Ultraviolet radiation: visible light and infrared radiation could trigger pigmentation too, under specific circumstances.
Hormonal changes: such as pregnancy, breastfeeding, menopause, hormonal treatment, medical conditions involving the endocrine system (aka, the glands that release hormones into the blood) and stress.
Trauma to the skin: this causes inflammation, including aesthetic treatment such as laser resurfacing or surgery.
Melasma is more apparent in women, compared with men, and often occurs “in older age and almost never happens in the childhood or young age, except for post-inflammatory pigmentation,” says Dr Meder.
We may be used to seeing melasma on paler skin tones, but it can affect all skin types and tones. “Some skin types are linked to higher risk because of the anatomy of the skin and specific physiology of pigmentation,” says Meder. “People with an Asian skin genotype are in a higher risk zone which can be higher or lower genetically. Whereas those with darker skin have a higher risk for pigmentation and Caucasian type is at the lower risk”.
Is melasma dangerous?
Just like with most skincare conditions out there – acne and eczema come to mind – melasma is not necessarily dangerous to your health or well-being, but it can have an impact on your mental health.
If you are struggling, always make consulting your doctor your first port of call.
What treatments help with melasma?
It’s not all doom and gloom and don’t you worry, we’re here with the solutions.
“If you’re going to be serious about clearing it the best option is having a medical treatment called hydroquinone,” believes consultant dermatologist, Dr Emma Craythorne. Hydroquinone is a de-pigmentation or skin-lightening agent that usually comes in a cream format if prescribed.
A topical prescription of the ‘it’ ingredient of the moment, tretinoin, might also be one to look into and is often used to treat acne and fine lines. “Tretinoin can be a bit irritating on the skin, so it’s important to try and avoid inflammation with a good moisturiser to support the skin barrier,” advises Dr Craythorne.
Basically, get to your dermatologist ASAP.
How to treat melasma at home
If you don’t want to trek to your Derms office, there are also some over-the-counter fixes you can add to your skincare routine.
“Melasma is a diagnosis that has very effective medical treatments in order to get clearance but it also needs to have a very strict skincare routine to protect you from any ultraviolet radiation and oxidative stress,” says Dr Craythorne.
As always, there are some important ingredients in your skincare to look out for. “Cosmeceuticals can be helpful, but not as good as the medical treatments. These are vitamin C, liquorice, silymarin and soya all have shown some benefit,” says Dr Craythorne.
Best serums for melasma
SkinCeuticals Silymarin CF Vitamin C Salicylic Acid Antioxidant Serum
L'Oreal Paris Revitalift Clinical 12% Pure Vitamin C Serum
Beauty Pie Superdose™ C C- Suite Rapid Action Power Vitamin C Brightening Serum
The Body Shop Vitamin C Glow Revealing Serum
Sunday Riley C.E.O. 15% Vitamin C Brightening Serum
La Roche Posay Pure Vitamin C 10 Serum
She also adds: “Azelaic acid is helpful for most people. All these drugs work in slightly different ways to address the melasma and that’s why using all of them is really hitting the melasma hard.” If you want to make things even simpler, Dr Craythorne created KLIRA, an online dermatology service, so the experts can formulate all the ingredients you need in one bottle.
Azelaic acid gallery
SkinCeuticals Phyto A+ Brightening Treatment
Facetheory Colloidal-C Anti-Redness Toner T3
The Ordinary Azelaic Acid Suspension 10%
Paula's Choice 10% Azelaic Acid Booster
Skin + Me Brighten + Boost Calming Azelaic Acid Serum
THE INKEY LIST Super Solutions 10% Azelaic Acid Serum
Dr. Sam's Flawless Brightly Serum
Q+A Azelaic Acid Balancing Serum
Boots Ingredients Azelaic Acid Gel Cream 30ml
I know we bang on about it a lot, but wearing sun cream is vital when it comes to keeping melasma at bay. “Protecting the skin using topical antioxidants and broad spectrum SPF is absolutely the most important thing anybody can do,” stresses Dr Craythorne.
Best SPF
Avene Avene Antirougeurs Unifying SPF 30 Tinted Moisturiser for Skin Prone to Redness
BYOMA Moisturising Gel Sunscreen SPF30
Fenty Skin HYDRA VIZOR Mineral SPF 30 Moisturizer With Niacinamide
Garnier Ambre Solaire Ultra-Light Sensitive Sun Protection Face Fluid SPF50+
