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Ask Dr. Schultz | Skin Care Guides | Your Guide to Melasma

Your Guide to Melasma

Melasma is a skin condition characterized by hyperpigmentation and brown spots. It is underdiagnosed, but all too common. You may have experienced this when pregnant, while going on or off birth control, or even after overexposure to the sun. It can be incredibly frustrating when it crops up because there’s not always clear information out there on how to help reduce it. But over his four decades in practice, Dr. Schultz has helped thousands of patients transform their discoloration due to brown spots of all kinds—including those from melasma—into glowing, even-toned skin. And he’s here to help walk you through your own transformation.

With over 10,000 patient visits a year (including four generations of patients from just one family), Dr. Schultz has seen it all. And because he understands this skin condition, you can take control of it and understand it, too. It’s time to get serious about transforming your discoloration back into your clearest, freshest skin, and with just a little bit of knowledge and the right ingredients in your medicine cabinet, you’ll do just that.

What is Melasma?

Melasma is a skin condition that manifests in the form of dark, discolored patches on the face. It usually appears on the forehead, below the eyes, and along the upper lip in a horizontal band. The discoloration from melasma occurs due to hormonal imbalances, which cause normal pigment cells to overproduce pigment in a mask-like distribution. Melasma commonly occurs in pregnant women, so much so that it is often referred to as “the mask of pregnancy.” It’s a result of the reaction of normal pigment cells to female estrogen, which is why this condition often begins during pregnancy or when starting a new course of birth control pills. When melasma occurs in the non-pregnant population, the onset can be caused by stress, thyroid disease, and continual overexposure to the sun.

In this video, Dr. Schultz gives you a brief explanation of melasma to better understand the condition:

Melasma Causes

There are a few reasons why melasma may show up on your skin. Melasma commonly occurs in pregnant women, which is why it’s often called the “mask of pregnancy.” When melasma occurs in the non-pregnant population, the onset can be caused by beginning a new birth control pill, stress, thyroid disease, and continual overexposure to the sun.

Pregnancy Melasma

As we mentioned above, melasma is referred to as “the mask of pregnancy” because of how often this skin condition occurs in pregnant women. When you become pregnant, your body begins making more estrogen to support the pregnancy, and melasma sometimes occurs as a reaction of normal pigment cells to that hormone.

Sun Exposure and Melasma

Because exposure from the sun creates more brown pigment in your skin (hence why you get a tan from being outdoors), even normal amounts of sun exposure can exacerbate or cause melasma in your skin. Watch Dr. Schultz explain how sun exposure and melasma go hand in hand:

Melasma vs. Age Spots

Melasma is, in effect, brown discoloration, which is simply a collection of excess brown pigment. Although brown discoloration may appear at the surface of the skin, it actually runs many layers deep. Melanocytes, our pigment-generating cells, are located in lower layers of the skin and create pigment (and in the case of discolorations, excess pigment). As our skin sheds and new layers rise up and are revealed, the brown discoloration that was once deep within the skin also rises to the surface. If the melanocyte continues to create excess pigment, then it will exist within all of the layers, all the way down to the melanocyte.

How to Get Rid of Melasma

Melasma is a difficult condition to deal with, but with the right knowledge and powerful ingredients that are proven to work, it’s absolutely something that can be conquered.

Melasma Removal

To treat the discoloration already on your face, you will need a combination of exfoliation and bleaching products. Bleaching products with peptides are the newest advancement in this field, and will help lighten the discoloration without lightening the normal colored skin around it. In addition, antioxidants are key in brightening the skin and protecting it from further damage from the sun. But, none of these treatments will make any difference without diligent use of sunscreen.

In particular, people with melasma should use a chem-free sunscreen. Here's why: traditional, carbon-based sunscreens protect the skin by absorbing the sun's rays. Melasma-affected skin is so sensitive that the heat created by this absorption process creates further damage and causes more discoloration. Chem-free sunscreens, on the other hand, block the sun’s rays and therefore don't produce heat. So if you have melasma, be sure the active ingredients include only titanium dioxide or zinc oxide, telltale signs that you're using a chem-free sunscreen.

Melasma Treatments That Work

Dr. Schultz has seen a lot of success with his patients who have used the following products and procedures, or a combination of them.

Sunscreen for Melasma

Dr. Schultz says, “Even if you help remove discoloration with an exfoliant and prevent further discoloration with a vitamin C product, unless you’re also using an effective sunscreen every day, the color is just going to come right back, because sunlight on these hypersensitive pigment cells can create additional discoloration quicker than you can treat it.” The Solar Defense Sheer Sunscreen SPF 50 uses the newest chem-based and chem-free technology for optimal protection against sun exposure. This sheer and light sunscreen still contains a high SPF, which will help prevent the deeper darkening of existing brown patches and the appearance of future discoloration.

Chemical Peel for Melasma

Using exfoliating skincare products with Tetrafoliant® can help to safely and gradually reduce your unwanted brown pigment caused by melasma. Those products work by removing the layer of superficial dead skin cells that trap excess pigment, thus lightening hyperpigmentation. With the Tetrafoliant® 8% Peel Solution, you can save yourself a trip to the dermatologist by using this at-home peel. Dr. Schultz’s gentle Tetrafoliant® safely reduces excess pigmentation, while providing a gradual and non-irritating way to introduce exfoliation to your daily skincare regimen. Once your skin is used to the Peel Solution, you can move onto the Tetratfoliant® 10% Peel Pads to get an even higher strength of Dr. Schultz’s powerhouse exfoliating ingredient.

Creams for Melasma

While Dr. Schultz doesn’t recommend a cream for melasma, he does recommend a serum. The difference between a serum and a cream is that serums tend to be lighter and more highly concentrated than traditional thick creams.

While exfoliation is the necessary tool to combat melasma at the surface of your skin, using a serum that contains vitamin C is crucial in cutting off the deep-rooted source of excess pigment. In fact, it is a powerful antioxidant that prevents melanocytes from over producing pigment. In doing so, it inhibits new discoloration from forming. Combining three of the most effective forms of vitamin C, the Triple Vitamin C Serum  is proven to reduce the appearance of hyperpigmentation and dark spots. Additionally, it will properly nourish the areas on your face that are not affected by the “mask”-like distribution of melasma to reveal smoother, brighter, and more youthful-looking skin.

Laser Treatments for Melasma

Beyond at-home products, there are also laser treatments available for this skin condition. However, keep in mind that although you may want to treat your melasma, you still want to look like yourself. That’s why Fraxel Laser Facial Retexturing is an amazingly effective, non-invasive solution for the brown discoloration caused by melasma. Fraxel helps remove brown discoloration and is an incredible technology for repairing uneven skin tone. Whether you’re dealing with sun damage, melasma, brown spots or unwanted freckles, Fraxel removes discoloration and stimulates natural collagen production in the skin. You’ll gain back an even skin tone that you’ll love to show off, even without makeup.

Microneedling for Melasma

If peels do not adequately fade your melasma, microneedling could be successful in destroying the excess pigment. However, the process will also most likely cause inflammation, which in turn causes additional excess pigment and discoloration. The resulting cycle of treatment and inflammation is the risk of using this approach. For microneedling to be successful in treating melasma, it must be expertly and gently performed in order to avoid causing new inflammation.   

Why Is Melasma Challenging?

Not only do the unwanted symptoms of melasma cause embarrassment and discomfort, but they can be very difficult to treat. The challenge is that hyper-sensitive pigment cells are more likely to generate excess pigment during treatment from external stressors (e.g., UV damage), producing even more excess pigments. Therefore, treatment can often be counterproductive if not done properly.

Your At-Home Regimen

To help reduce the appearance of your melasma at home, start with a daily exfoliant to get rid of brown spots. In addition, use an antioxidant like vitamin C to brighten your skin and help reduce hyperpigmentation. And most importantly, always use a chem-free sunscreen to prevent further brown spots from developing. You can get each of these in products individually or together in our BeautyRx Dark Spot Treatment Kit. This three-step skincare regimen combats the discoloration that accompanies melasma. Keep in mind: these treatments don't ensure that your melasma won't come back or that it will be completely lightened. If at-home remedies are not treating your melasma effectively, you should see a dermatologist who can do medical-strength chemical peels.

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