Melasma

The two main causes of melasma are hormonal surges (it is referred to as chloasma when caused by pregnancy) and prolonged sun exposure. Women taking birth control pills or hormone replacement therapy are also at a higher risk of developing melasma. The hormonal surges common during menopause can also increase the risk of developing melasma. An overabundance of the female hormones estrogen and progesterone are believed to overstimulate the melanocytes, which are the cells in the epidermis responsible for producing melanin. Women with tan/light brown skin living in predominantly sunny climates are the most susceptible to the facial hyperpigmentation.

Hyperpigmentation from melasma does not pose a risk to the skin or general health. However, prolonged exposure to the sun’s UV rays can cause premature aging and wrinkles, and increase the risk of skin cancer. In rare cases, dark facial patches can also be a symptom of underlying health problems like thyroid disease or Addison’s Disease (Melasma Suprarenale). Although the spots and pigmentation caused by melasma are typically distinguishable from the signs of skin cancer, scheduling regular check-ups with a dermatologist is important to monitor for changes or abnormalities from new or existing moles. Skin cancer is the most common form of cancer in the United States but is highly treatable when diagnosed in the early stages.

When caused by hormonal imbalances from birth control pills, hormone therapy, or as a side effect of certain medications, adjustments can usually be made to the dosage. Because melasma is also caused by sun exposure, protecting the skin from UV rays is the best way to prevent pigmentation and skin cancer. Dermatologists recommend regularly applying a sunscreen of at least 30 with broad-spectrum protection, reapplying every two hours while outdoors for prolonged periods. Protective clothing, sunglasses, and wide-brimmed hands are also important for protection, in addition to sunscreen.