Melasma – Discoloration / Brown Spots: A Common Bothersome Condition

Melasma – Discoloration / Brown Spots: A Common Bothersome Condition

Does a glance in the mirror show darkened patches on your face? These brown or grayish-brown blotches, typically on the forehead, chin, cheeks, upper lip, or nose, may signal a condition called melasma.

Melasma is a common condition of increased pigmentation of the skin of the face, whicfh looks like brown spots or patches of various shades of brown.  It is most prevalent in women of child bearing years.  Commonly, it is known as the mask of pregnancy; however, it can be related to several other factors as well and is not limited to women who are pregnant. Although much more common in women, it can occur in men as well. It also can rear its ugly head when the weather gets hotter and we are out more in the sun. You’re more likely to get melasma if you have a darker skin type, probably because your skin naturally has more active pigment-producing cells, according to the American Academy of Dermatology. Melasma appears when these cells become hyperactive and produce too much pigment in certain areas of the skin. The mechanism is similar to what causes brown age spots and freckles, but melasma patches tend to be larger.

This condition which can be mild or severe is caused by sun exposure as well as hormones.  The sun is the big culprit in triggering melasma. Underlying factors such as hormonal changes may not manifest until a person goes on vacation and spends time in the sun or during the summertime when more time is spent in the sun. Melasma can be caused or worsened by not only the sun’s rays, but also heat and visible light. This means that even sunscreens that protect against skin cancer aren’t enough to ward off melasma. This makes treating melasma a challenge, particularly in the summer months.

The first step in treating melasma is confirming with a dermatologist that your darkened skin patches are indeed melasma and not something more dangerous like a melanoma skin cancer.  The next step in treating melasma is to prevent the sun from aggravating the condition. This may require extreme diligence. The sun is stronger than any medicine.  Although it won’t protect entirely, sun protection is the main preventative measure. But keep in mind that not all sunscreens are created equal, you need a sunscreen that blocks not only the sun’s rays, but also its light and damage from heat.

There are two main types of sunscreens:

  • sunscreens that use chemicals, such as oxybenzone
  • sunscreens that use physical blockers, such as zinc and titanium dioxide.

You will want to choose the non-chemical, blocking sunscreen, because that will absorb more of the damaging UV rays.

Sun protection also involves wearing of protective clothing when outside such as wide brim hats.  Most people think they are avoiding sun by not spending time outside; however, UV rays penetrate windows.  I also recommend a UV clear tint be applied to the front windows and windshield of vehicles for those who spend a lot of time in the car. These tints absorb the harmful UV rays which is also beneficial to those who have had skin cancers. With so much outdoor activity, especially from April – October, it is hard to escape the factors which trigger it and make it worse. Dermatologists and their Aestheticians can help the condition and advise on the proper ways to treat it. Mild TCA peels are done in the office and peel deep into the skin bringing pigment up to the surface.  These peels can expedite the process of resolving melasma; however, it may take several months in combination with a good topical home regimen.  Laser Treatments can sometimes be beneficial but not in all patients.

Treatment of melasma also involves the use of creams applied to the face morning and night.  However, sunscreens are the most important in prevention of new spots.

There’s more you can do on your own to help your skin heal and prevent future damage. In addition to reducing sun exposure, try these steps:

Establish a good cleansing regimen. Environmental pollution can contribute to melasma. Airborne pollutants can bind to the skin and corrode the protective surface, making it weaker and more susceptible to sun damage. Clean your skin every night before bed with a cleanser.

Combat skin stress with antioxidants. Vitamins C and E can help heal damage from sunlight. So, dab on a few drops of a serum that contains these vitamins to improve skin health and ward off the harmful effects of sun exposure. We recommend a new product called Daily Power Defense. It also protects against blue light from computers and cell phone screens.

Be patient. Even with treatment, it may take months for melasma to clear up. There’s no overnight fix.

Be diligent. Melasma will be quick to return if you’re not careful about sun protection. So, long-term maintenance requires an ongoing commitment to protecting your skin.

Seek the advice and recommendations of Dermatologists and their Aestheticians who can find the right answers with a comprehensive approach of prevention, home and office treatments.


Kyle Coleman, MD is a Board Certified Dermatologist who practices in Thibodaux and Metairie. He is an expert and international speaker in non-invasive and minimally invasive cosmetic techniques.

Kelsey Haydel, Licensed Medical Aesthetician, has 8 years of experience in the specialized field of Medical Dermatology Aesthetics. Working alongside a Dermatologist and with medical grade products and equipment, Kelsey shares her extensive knowledge of products, laser treatments and the latest advances in skincare such as microneedling for collagen production.

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