It’s a fact of life: we’re going to see some changes on our faces as years go by. I still remember the birthday when I woke up and noticed that there were two hyper-pigmented spots under my eyes that I swear weren’t there before. Although aging can be a contributing factor, hyperpigmentation comes in many forms and has a variety of causes, like acne scarring, sun damage, or discoloration from eczema or psoriasis. But there’s one form of hyperpigmentation that’s unlike the rest, and that form is melasma. I talked with FACILE dermatology + boutique co-founder Nancy Samolitis, MD, FAAD all about this unique form of hyperpigmentation, why it shows up, and what you can do about it.
Melasma is a common skin condition characterized by patches of uneven skin pigmentation, usually seen on the face. The patches are darker than normal skin tone and may have lighter spots speckled within. We often see it on the forehead, cheeks, and upper lip. A dermatologist can confirm that diagnosis.
Melasma is caused by a combination of factors, including sun exposure and hormones such as estrogen and progesterone. It is definitely more common in women and is known to be triggered by female hormones. Melasma can occur during pregnancy and in women taking birth control pills, but often occurs in women who don’t fall into these categories. We rarely see it present in men. The exact mechanism of how and why hormones stimulate this reaction is poorly understood scientifically.
Melasma sometimes goes away on its own, but it can be chronic for many years or decades. In some cases, women who develop it during pregnancy or while on birth control pills may experience improvement in their condition when they are no longer pregnant or on the pill, but they often require treatment to clear more quickly. Although many of our treatments can fade it significantly, we don’t usually consider it “cured “because it often recurs with sun exposure and warmer temperatures.