Does summer have your skin all out of whack? That blotchy pigmentation may be a common skin condition called melasma, which is known to be worsened by sun exposure. It shows up as a brownish discoloration on the cheeks, forehead, nose, and upper lip. Occasionally, it can also present on other areas of excessive sun exposure such as the forearms and neck. The prominent pigmentation can be extremely bothersome both socially and emotionally, and has been shown to negatively impact quality of life.
There is still much to be learned about melasma and the exact cause is still unknown. Various triggers of melasma have been identified including chronic ultraviolet light exposure, genetics, hormonal therapy, thyroid disease, pregnancy, certain medications and even your cosmetic regimen may be playing a role. Recent evidence suggests visible light may aggravate this skin condition.
Because not much is known about the cause of melasma, it can be quite challenging to treat, but new and exciting treatment options are proving effective at lightening this stubborn skin pigment. Your dermatologist will likely prescribe a topical Vitamin A cream, hydroquinone, topical steroid, or triple combination cream including each of these ingredients. Novel pigment brighteners and botanicals are making their way down the pipeline, improving our topical options and enhancing results. Laser treatments, chemical peels, dermabrasion and intense pulsed light are additional options used in combination with topical therapy.
Alternative treatment options for melasma are on the rise, and we are learning more about ways to increase delivery of brightening medications into the skin. Laser, iontophoresis, and microneedling, to name a few, are exciting treatment options showing promising results. More recently, an oral medication, tranexamic acid, has come into the therapeutic realm and may be an option for resistant cases of melasma.
At home essentials include diligent sun protection using a broad-spectrum sunscreen. Iron oxide, an ingredient that has been shown to be the best visible light blocker, may be particularly helpful in melasma. Topical antioxidants are also a must. SkinCeuticals Phloretin CF is one of my favorites because it has been scientifically proven to protect your skin against atmospheric aggressors such as pollution and ozone. Avoid waxing as the heat and inflammation in the skin often causes pigment in the treatment area. It is important to see your dermatologist to optimize your skin care regimen and create a customized treatment plan to get your skin from out of whack to back on track.
-Holly Singletary, M.D.
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Holly Singletary, MD