What is Melasma?
Melasma is a very common skin issue that causes patchy brown or gray discoloration on the face. It is also called the ‘pregnancy mask’ because it is commonly triggered by hormones caused from pregnancy. It typically appears on the cheeks, upper lip, forehead, and chin.
Who Gets Melasma?
Women ages 20-50 years old are most likely to get melasma. Because it is hormonally driven skin condition, it primarily affects women. According to the American Academy of Dermatology only 10% of people with melasma are men. People with olive or darker skin, such as those of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent are more likely to get melasma. Genetics are also an issue; People with relatives who had melasma are much more likely to get the skin condition.
What Causes Melasma?
The reason melasma is common in women is due to the underlying cause being the female sex hormones estrogen and progesterone. Pregnancy, birth control, and hormone replacement therapy all contribute to the occurrence of melasma in women.
While the exact causes are still generally unclear, Dermatologists believe it likely occurs when the color-making cells in the skin (melanocytes) produce too much color. Those with darker colored skin are more prone to this condition because they have more active melanocytes than people with pale skin.
Another major cause is sun exposure. Ultraviolet light from the sun stimulates the melanocytes and can make melasma return after fading. This is the reason many people experience worse conditions in the summer.
Also, heat can trigger melasma, and after exercise and sweating, those with melasma may notice the pigment is worse. The skin will usually calm down once the body has cooled off. Steaming the face can also trigger the unwanted response and some laser treatments can actually cause melasma. Those with darker skin tones should be extremely careful with laser treatments as it can put too much trauma and heat on the skin, resulting in the appearance of melasma.
Birth Control & Melasma
Since melasma is caused by changes in hormones, the pill can sometimes cause or worsen this condition. Sudden changes in hormones can trigger melasma or make it worse. Many people report melasma for the first time when they begin taking the pill. If you’ve never taken the pill before, and know there is a history of melasma in your family, you should consider this before taking the pill or making any changes to hormone therapy.
Another alternative to quitting the pill entirely is to start taking a minipill. The minipill is similar to regular birth control pills, except it's progesterone only. It's recommended for women who are breastfeeding, have certain health issues, or for women who have had melasma. As always, you should schedule an appointment with your gynecologist to discuss the best option for you.