Understanding Melasma: Everything You Need to Know, From Triggers to Treatments

Melasma, often dubbed the "pregnancy mask," is a type of hypermelanotic disorder of the skin characterized by patches of pigmentation, particularly on the cheeks, forehead, nose, upper lip, and chin. 

Before zoning in on the right treatment, it's important to understand what melasma is, what triggers it, and hot to properly care for your skin to help minimize its appearance.

Types of Melasma

Before delving into its causes and treatments, it's crucial to understand that melasma manifests in different histological types and can affect individuals differently. The most common types include:

1. Epidermal Melasma: In this type, melanin is distributed throughout the epidermis, the outermost layer of the skin. These patches may appear darker and respond better to topical treatments.

2. Dermal Melasma: This deeper type of hyperpigmentation may appear lighter on the surface but can be more challenging to target, as the pigmentation is located deeper in the skin layers.

3. Mixed Melasma: In this case, hyperpigmentation is scattered in both dermal and epidermal layers of the skin. 

Causes of Melasma

While the exact cause of melasma remains unknown, it has been associated with three main triggers:

1. Hormonal Fluctuations: Melasma is frequently observed in women, with around 50% first noticing it during pregnancy. Hormonal changes during pregnancy, as well as the use of oral contraceptives and birth control, can exacerbate melasma.

2. Genetic Predisposition: Family history of melasma increases the likelihood of developing the condition, particularly during pregnancy.

3. UV Exposure: Ultraviolet (UV) and visible light play significant roles in melanin synthesis, making melasma more prominent, especially during the summer months. Prolonged exposure to sunlight, even indirectly, can trigger melasma.

Will Melasma Go Away on Its Own?

Melasma is generally classified into transient and persistent types. Transient melasma typically disappears within a year after the hormonal stimuli cease, such as after pregnancy or discontinuation of oral contraceptives. However, persistent melasma, caused by factors like UV exposure, may persist even after hormonal triggers are removed. While melasma may resolve on its own in some cases, clinical relapse is common.

Even if you do everything mentioned above and you still develop melasma- what then? How can you treat it?

Many different skincare ingredients have been studied for their action to control and help regulate melasma. The combination of different topical agents and treatments like chemical peels have been proven to yield the best and most long-lasting results.

Treating and Minimizing Melasma at Home

If you are not willing to try topical prescription medication like hydroquinone and topical steroids because of their side effects, then you should understand that the management of melasma is challenging and requires a long-term treatment plan with the right skincare products!

Before you start to get overwhelmed by all the brightening products out there that promise to fade hyperpigmentation, just start looking for these tried and tested ingredients:

Tyrosinase Inhibitors: Melanin Synthesis is a complex process triggered to help the skin against photo damage. If you’ve ever used any skincare products to tackle hyperpigmentation, then you might have heard the word Tyrosinase. This enzyme is naturally occuring on the skin and plays a huge role in enzymatic browning and melanogenesis, which is what triggers melanin synthesis in the skin.

Ingredients to Target Melasma:

Tranexamic Acid: Stops melanin synthesis, fades dark spots, discolouration and melasma

Azelaic Acid: Powerful antioxidant, calming, soothing and brightening.

Kojic Acid: Lightens discolouration and keep it from recurring

Alpha Arbutin: Reduces age spots, acne scars, and post-blemish redness and effectively regulates melasma

Retinoids: Vitamin A derivatives have been widely used to help control melasma primarily as penetration enhancers for other brightening agents but recent studies have shown that they have a great impact on melanogenesis.

Tinted SPF: The single most important skincare product when it comes to treating melasma and hyperpigmentation. Diligent sunscreen use is paramount in the fight against melasma. SPF usage can prevent melasma in high‐risk individuals, can improve melasma severity, and can reduce clinical relapses. High SPF, tinted sunscreens that contain iron oxides and a broad protection against UVA/UVB and UVA1 and HEVL have been proven to be superior to other non-tinted, basic formulas when it comes to treating melasma.

Our Top Product Picks For Melasma:

Tyrosinase Inhibitors:

• Trans3x Concentrate

• Marini Luminate

• Lotion P50 PIGM 400

• Serum PIGM 400

Tinted Broad Spectrum Sunscreen 

• Melan Sunscreen SPF 50+

• Marini Physical Protectant

• EltaMD Clear Tinted

 

Professional Treatments

The million dollar question when it comes to professional treatments for melasma is "Will laser help clear my melasma?" and the answer is, in most cases, no.

Although IPL and laser treatments can be really effective for sun damage and dark spots, when it comes to melasma, it gets a little complicated. It can, temporarily, reduce the pigment on the surface of the skin, but in most cases the heat and energy emitted can trigger over-production of melanin, causing the condition to worsen overtime. Resurfacing and ablative laser treatments can also worsen the condition once the skin starts healing itself. It's important to consult with your dermatologist and trusted skin expert to ensure the treatment you're chosing is right for you, and your skin needs. 

When it comes to treating melasma in-cabin, Cosmelan has been our most-trusted and effective treatment. Not only does it drastically minimize and fade melasma, but it successfully keeps it from reappearing with the dedicated at-home regimen.

While regulating the overproduction of melanin in melanocytes and controlling the appearance of new dark spots, this treatment operates through a dual-action approach:

Regulating Action: Cosmelan functions at two primary levels. Initially, it inhibits the activation of tyrosinase within the melanosome, thereby reducing oxidative stress and subsequent melanin synthesis. Secondly, it contains copper chelators (Cu2+) to further inhibit tyrosinase function. Additionally, Cosmelan blocks the transfer of melanosome to keratinocytes, preventing the movement of pigment to the skin's superficial layers.

Corrective Action: The Cosmelan peel diminishes melanin synthesis, thereby reducing the intensity of dark spots. Moreover, it stimulates epidermal renewal within the stratum corneum, effectively eliminating the accumulation of melanin.

The Cosmelan protocol is safe for all skin types and is a 6 month intensive treatment that includes 1 single peel session in the beginning of the treatment followed by a 6 month at-home regimen. 

Find more information about Cosmelan here, or book a skin consultation here.

 

 

Cited Cources: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9936885/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807702/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790748/