Melasma, also known as pregnancy mask, or hyperpigmentation, is an extremely common issue for women. An increased level of the hormone estrogen, either caused by pregnancy, a change in hormone levels, or birth control pills, can cause dark patches on the face. Melasma and sun spots are sometimes hard to tell apart, but Melasma generally appears as patches around the mouth, on the apples of the cheeks, on the forehead and around the jawline. Sun spots, or sun damage are generally spots of darker pigment, or large freckles. I personally have a hard time telling the two apart visually.
How to prevent Melasma
If your estrogen rises, due to pregnancy or taking the pill, there’s a good chance you could develop Melasma. The single best way to prevent it is by staying out of the sun (and tanning booths) completely. The second best way is to wear a good sunscreen at all times - even if you leave the house for only 5 minutes to run an errand. Zinc Oxide based sunscreens are the absolute best for protecting your skin from the sun, and I write in depth about Zinc Oxide sunscreens here. I would recommend a sunscreen with at least 10% Zinc Oxide, and at least SPF 30 at all times! Make sure to reapply if you are outdoors for more than a few hours, and reapply after swimming or sweating. Unfortunately, Melasma can happen quickly, and just one day of sun exposure without a good sunscreen can cause it. Once you get Melasma, it’s difficult to get rid of, at least quickly, so protection is by far your most important measure.
How to get rid of Melasma
If you are pregnant, you don’t want to be doing professional skin care treatments, or using most prescription skin products, nor do you want to use a product with Hydroquinone as an active ingredient. Luckily Zinc Oxide is safe to use while pregnant. DermaDoctor has an informative article that talks about Melasma in detail. There are several topical options to treat Melasma, and they are supposed to be applied just to the dark patches, not to your whole face. That way you are just lightening the dark areas, rather than lightening your whole face. Unfortunately, it’s not easy to apply a cream just to small areas of your skin, at least from my own experience.
Hydroquinone, a skin lightener, is the most common used ingredient for Melasma, and sun spots. It has elicited some controversy, because a lot of people claim it can be hazardous. Ironically, it can make you more sun-sensitive, so if you are not staying out of the sun, you can make your Melasma worse! I am not sure what to believe about the safety of Hydroquinone, but a lot of reputable skin care companies still use the ingredient. Glycolic Acid, and Tretinoin, or Retinol are also used by themselves, or in combination, to treat Melasma. Kojic acid, Azelaic acid, Licorice extract, Salicylic acid and Vitamin C are also ingredients that can possibly lighten your dark patches.
My experience with Melasma
I’ve had Melasma just around my mouth area, which I got from being on the pill (to treat acne). Oh the irony! I have also had sun spots or freckles, which are from sun damage, not from hormonal fluctuations. I’ve tried gels with Hydroquinone and Salicylic acid, and didn’t see any results. I had small tiny patches of Melasma, so it’s hard to just put the gel on that tiny area. When I went off the pill, my Melasma went away. When I went back on it, I was using a good Zinc Oxide sunscreen and avoiding the sun, so I didn’t have much Melasma surface this time around.
Photo Facials for Melasma?
Photo Facials, or lasers used to lighten dark spots work well on sun damage. However, at the Medical Spa I worked at, the Estheticians said they saw poor results when treating Melasma. So I would consult a Dermatologist to see if lasers would or wouldn’t be an option for Melasma. In the mean time, it’s not easy to treat Melasma quickly, so stay out of the sun!!!
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September 24th, 2007 at 6:21 pm
Wow! I did not know that melasma can result from taking the pill. (actually i didn’t know that it can result from pregnancy either -.-). And I’m actually planning on going on birth control real soon too! thank you so much for the heads up!!!!!!
September 25th, 2007 at 5:53 am
I got melasma when I was pregnant on my forehead. You dont really know when you’re getting it until later. Or maybe that was just me but all of a sudden one day I noticed it!
January 24th, 2008 at 7:46 pm
Hi.. thank you so much for the info. How long after you went off the pill did you notice the melasma go away. Did it completely go away? Thank you again!
January 25th, 2008 at 5:35 pm
Allie,
I didn’t have really bad melasma, but I had tiny little patches around my mouth mostly. I would say it probably took a month or two before they went away when I stopped the pill. I stopped noticing the spots, so I think they were gone. But my melasma wasn’t that bad to start with, so it might not go away completely if you go off the pill, but it should improve a lot. And wearing sunscreen definitely helps, since the sun is what makes melasma a lot worse.
May 16th, 2008 at 6:05 am
I had 2 dark patches appear (1 on each cheek) after a miscarriage around 1 1/2 yrs ago. I have 3 children, and I am currrently pregnant with our 4th. For years in my teens/20’s I was taking oral contraceptives and I never wore sunscreen because I never burn and love a tan. I have not taken the pill for around 3 years. Recently, a new dark spot appeared on my nose and they seem to appear overnight. I have always had even-toned, clear skin and a nice, tan complexion. I noticed last year that anytime I got sun, the spots got darker and worse. I went the the derm dr. and from now on I wear sunscreen (45spf w/zinc, for uva, uvb rays) 365 days per year. I even keep a travel tube in my purse. I am anxious to get another consultation after this pregnancy regarding laser treatment. I can tell you that these spots did not fade at all in the year between pregnancies and I was advised that they most likely will not. In all of pregnancies, I have always developed a dark area on my upper lip that always fades w/in months after birth. Not these ones though. I fear they will keep forming. I cannot use any treatment creams during pregnancy, just sunscreen. My sister did get me this stuff from the Elizabeth Arden collection that worked last year. The spots actually lifted/peeled right off my face, it was very encouraging. But they came back after I had to stop using it. My advice to all is sunscreen that face, I never thought that I would encounter this problem. NO one else in my family has pigment issues, and I always had an envious complexion. I never wore make-up until this happened, and I am in my 30’s. If anyone has any home remedies, let me know. I have already tried vinegar, lime juice, even vicks vapor rub, None of it works. Also any advice about laser treatments, any personal experiences would be very helpful… thanks.
May 18th, 2008 at 1:40 am
Kim,
Have you tried products with hydroquinone in the past to lighten your dark spots? I wrote about it here: http://www.savvyskin.com/hydroquinone-update . After you have your baby, you could also ask your doctor about getting a prescription hydroquinone product (which is 4%, rather than 2%). What sunscreen do you use? I’m just curious about the percentage of zinc oxide it has.
Once it’s okay to try the hydroquinone, I would use it daily for 2 months, and also make sure you use a really good sunscreen, plus avoid the sun as much as possible. If none of that works, you could consult about getting laser treatments. The only thing is that lasers don’t always work on melasma, but it’s definitely worth trying photo facials if you can afford it, or if the treatment comes with a guarantee.
June 12th, 2008 at 2:13 pm
I have struggled with melasma for 5 years. I think it came on due to birth control, but it never left. I am an avid outdoors girl, so here is what works for me.
First, I apply a vitamin c serum in the am after I cleanse. Then I apply sunscreen. I have many, but really like Bioderma Photoderm sunscreen. Lastly I brush Colorsciense mineral powder sunscreen ( not the regular powder) to take away the shine and add a layer of protection.
In the evenings I alternate night with a retin-a prescription and mama lotion. The mama lotion can also be substituted with a good alpah hydroxy serum. I follow with a light moisturizer that does not contain any exfolliators since both the retin-a and the mama serve as one.
I reapply sunscreen at lunch time and in the car I swipe the Colorscience powder sunscreen. The only thing I add after a beach vacation or a full day in the sun is a hydroquinone cream to the affected areas in the evenings instead of the other creams for about two weeks until they have gone away.
If this seems like a chore, it is. However melasma is an ongoing condition for me and I hate to use foundation.
Good luck!