Learn From A Derm |

How to Treat and Prevent Melasma

Frustrated with skin patches that seem to show up out of nowhere? Here, we chat with a dermatologist about exactly what melasma is, melasma causes, how to treat melasma and how to prevent it from occurring in the first place.

Melasma is one of the most common skincare issues, especially among women, since it’s a skin condition that responds directly to hormone fluctuations. But there are certain things you can do to help prevent melasma from occurring, and wearing sunscreen every single day stands at the top of the list.

To gain more insight on this skin issue, we chatted with Deirdre Hooper, a New Orleans-based board-certified dermatologist and an associate clinical professor in the Department of Dermatology at both Louisiana State University and Tulane University. Here, she breaks down everything you need to know about melasma, including how to treat and prevent it.

What is melasma?

Melasma is a skin condition where you develop brown patches on sun-exposed skin. It commonly shows up on the upper lip, forehead or cheeks.

How does someone develop melasma and why does it usually occur?

Melasma is more common in women; it can be triggered by birth control pills or pregnancy. Genetic factors also influence whether you will get melasma. People with melasma have a greater number of estrogen receptors in affected skin cells. Some people notice improvement when they stop birth control pills, but not everyone will improve with stopping them.

“Broad spectrum sunscreens, especially those that protect from other forms of light other than ultraviolet, will be the key to help prevent melasma from occurring or worsening.”

What kind of relationship does melasma have with sunscreen?

Melasma is worsened not just by UV light, but also by visible light and infrared heat. We talk a lot about ultraviolet light (the one that gives us sunburns) but what about violet, blue light and all the energy that reaches our skin? These sources of light also contribute to the development of melasma.

What kind of sunscreen do you recommend for melasma?

Broad spectrum sunscreens, especially those that protect from other forms of light other than ultraviolet, will be the key to help prevent melasma from occurring or worsening. Also, sunscreens that contain antioxidants and tints give us broader protection. Physical blockers with tint are ideal, as tinted filters broaden your protection so you are protected not just from UV light, but also from visible and infrared light, which play a role in triggering melasma.

Two of the best choices are the 100% Mineral Matte Screen SPF 40 (this one protects from blue light) and the Daily Correct CC Cream SPF 35. Both of these are completely mineral-based and offer a tint to further protect you from melasma.

Aside from sunscreen, what’s the best way to prevent and treat melasma?

When it comes to how to treat melasma, the gold standard is topical hydroquinone, and usually percentages of 4 or higher are needed. Topical kojic acid, azelaic acid, niacinamide and soy are other ingredients that may help. In my practice, I often use chemical peels and lasers for stubborn melasma.

But all lasers have the potential to worsen melasma so I save them for stubborn cases. I use very superficial resurfacing lasers, like the 1927 thulium wavelength or lasers with very short pulse durations, like Q switched or picosecond, to break up pigment. Picosecond is great because it doesn’t produce heat and is my new go-to for melasma.

If you have stubborn melasma, the best thing you can do is see a board-certified dermatologist. Melasma usually requires prescription products to keep it under control. We don’t have a cure for melasma, so you need a doctor who can keep you up to date on the latest options.

+Have more questions about melasma and how to treat melasma? Leave them in the comments and we’ll get an expert to answer it!