Melasma, if you have it, is quite a pain in the ass. It's like an age spot on crack, only it doesn't care old you are. It's like someone painted a brown picture of Texas on your forehead/cheeks/lip/chin. The main problem with eradicating melasma, it's not an instant-gratification thing. Even with laser, it's a crapshoot. It can take months to years to really see the even & perfectly clear skin you had before you knew how good you had it. It's hard to find a formula that really works, and you have to be super vigilant about remembering to apply it. Melasma is a chronic condition, at best. Any sunny day can mean rebound pigmentation. Buckle up, sunscreen is about to become your religion.
In case you can't tell, my fellow melasma sufferers, I am one of your tribe. Mine showed up after I decided to switch birth control pills, and it got worse after a careless summer in the sun. Now it's a bit of a rollercoaster. Sometimes it's quite dark (after sun exposure) and then it lightens after a constant regimen of peeling, lightening serum, LED phototherapy and sunscreen.
What causes melasma?
- Melasma is triggered by hormonal changes. It's almost as if a certain hormone cocktail causes a bit of a sun allergy. It's so common during pregnancy that it's often called "pregnancy mask". Birth control pills can cause it, and hormone replacement medications.
- THE SUN. If you add a dose of sun exposure to that certain hormone cocktail, you've got a disaster on your hands. If you have melasma, SPF is your new BFF. A wide-brimmed hat is also pretty helpful.
- It also seems to be hereditary. If you have it, train your kids to wear SPF at an early age. Mainly the lady folk, only 10% of people with melasma are men.
Home care how-to:
- Obviously, a daily dose SPF. With melasma it's not about aiming for SPF 100, aim for broad spectrum coverage. If you see the term "PA+++" on the bottle, that is a dead giveaway that it's great for melasma. Here are my favorites in no particular order:
Coola PlantUV Face SPF 30 Unscented Moisturizer
La Roche Posay Anthelios 50 Mineral Tinted Ultra Light Sunscreen Fluid
Dr. Jart Premium Beauty Balm SPF 45 PA+++
Supergoop! Daily Correct SPF 35 CC Cream
- Melanin supressing active home care product(s) to actively lighten pigment. The main ingredient generally prescribed by dermatologists, hydroquinone, has been banned in many European countries because it is a suspected (or known, depending on who you talk to) carcinogen. Can we all agree that we'd rather have melasma than cancer? Read the labels and avoid hydroquinone, please! My favorite lightening ingredients are Kojic Acid, Azelaic Acid, Arbutin, and the amazing 4-n-butylresorcinol. There are tons of HQ-free lighteners out there, and many that contain exfoliating agents or retinoids to boost efficacy. Be aware that if you're using one with a retinoid or an exfoliating acid it will affect the outcome of any professional treatments (corrective peels, laser, microdermabrasion) because it will thin the skin. Here are my favorite non-HQ lighteners:
- A topical antioxidant support product. My favorite active antioxidant topical is Vitamin C (specifically L-Ascorbic Acid). Other good antioxidants for lightening? Alpha Lipoic Acid (also called Thiotic Acid) and Idebenone. I find that the L-Ascorbic acid form of Vitamin C is the most effective topical, so it's the main ingredient in all of the following:
- Exfoliate! It will stimulate cell turnover. For best results with melasma, a daily leave-on product works best. A combo lightener/exfoliator could be great (like iS Clinical White Lightening Complex or SeSderma Hydroquin Whitening Gel) or just a straight up retinoid or AHA. You'll have to talk with your esthetician (ahem... me?) about how far in advance of your clinical corrective peel to stop using your exfoliant. Here are a couple great ones:
The most important thing you can do to keep melasma from getting worse is absolute, crazy hyper-vigilance with the SPF. The most important thing you can do to lighten existing melasma is choose one of product from each section above, and use it every day. It will be frustrating, because it will take time and be gradual... But it's worth it! Don't forget to talk to your esthetician about what treatments they have to hasten the process (e.g. corrective peels, LED phototherapy, IPL)
