Hyperpigmentation of the skin isn’t uncommon, but unlike your run-of-the-mill sun spots, melasma is arguably one of the most clingy and temperamental skin conditions to treat once it appears.
Melasma, which appears as irregular dark patches along the forehead, upper lip and cheeks, is sometimes called “the mask of pregnancy” because it often occurs in response to hormonal changes associated with pregnancy or the use of oral contraceptives, said Dr. Brendan Camp, a board-certified dermatologist in New York City.
It’s not just pregnancy that can trigger melasma’s wrath, though. According to Dr. Serena Mraz, a board-certified dermatologist in Vallejo, California, it’s not uncommon for it to appear suddenly in non-pregnant adults after sun exposure on the face. And once it does occur, it requires only the smallest bit of sun to make its appearance worse.
“Melasma is most common in people with naturally darker skin but can also occur in very light skin types,” Mraz added.
When it comes to addressing the appearance of melasma, both Mraz and Camp said that diligent sun protection is one of the best forms of prevention, although other topical products should also be at play.
Mraz said that optimal treatment typically involves using topical agents that inhibit tyrosinase, an enzyme critical for the production of melanin.
“Combining an agent that blocks pigment with others that clean up free radicals and damaged cells, and mitigate the effects of inadvertent sun and environmental pollutants is ideal,” Mraz said.
A word of warning from Mraz, though: If any product or ingredient creates excessive irritation for your skin, it should be used with caution. This is because some irritation may cause post-inflammatory hyperpigmentation, exacerbating the appearance of melasma. (Here are some ways you might relieve irritation.)
To find out the exact ingredients and agents to use, as well as the best products that contain them, keep reading for suggestions and more guidance from Camp, Mraz and other experts in skin care.
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"In addition to cysteamine, this non-irritating serum contains stabilized L-ascorbic acid, phytic acid, acetyl glycyl beta-alanine and ginkgo biloba all in one potent [product]. This combination product acts to clean up free radicals, lighten overactive dark patches and improve skin tone and quality. It helps to reduce pigment, while brightening the skin," Mraz said.
"Sunscreen ingredients that will protect you from blue light (another trigger of melasma and hyperpigmentation) [are] iron oxides," said Rose, who suggested opting for broad-spectrum sunscreens that use either zinc oxide and/or titanium dioxide.
Camp suggested this popular tinted and lightweight sunscreen formula by Elta MD that features SPF 46, contains high-purity niacinamide and meets all of Rose's specifications.
This clinically formulated serum also contains a synthetically derived acid called HEPES that helps to exfoliate skin, and its hydrating glycerin and anti-inflammatory allantoin can keep skin feeling soothed rather than irritated.
Murphy-Rose recommends using it twice daily and always pairing it with a mineral sunscreen in the morning.
"Marketed as an acne medication, this retinoid was previously available only with a prescription and can be used to treat discoloration associated with blemishes and melasma," he said.
Retinoids are useful in promoting the skin's cellular turnover rate, which can lead to increased collagen production and smoother, brighter skin.
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