You Could Have This Common Skin Condition And Not Even Know It

It's often mistaken for the after effects of a sunburn.
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That dark patch on your cheek that you thought was a healing sunburn could actually be the sign of a common, though little-known skin condition called melasma.

Melasma causes brown or brownish-gray patches to appear on your skin ― most commonly on your face, along the forehead, cheeks, upper lip and chin. It’s caused by an overactivity of the skin’s color-making cells, called melanocytes, according to the American Academy of Dermatology.

The good news? It’s easily treatable and rarely dangerous. Melasma can range from mild to severe and affects more than five million Americans, 90 percent of whom are women. It is also more common among people with darker skin tones, including Latinos and people of African, Asian, Middle Eastern and Mediterranean descent, according to the AAD.  

Celebrities like Jenna Dewan TatumBrooke Burke and Ginger Zee from “Good Morning America” have spoken about their experiences with melasma. Recently, Sarah Silverman shared a photo of herself covering up in the sun due to her issues with the condition. 

“Many of my patients aren’t aware their discoloration is a common disorder named melasma,” Lauren Ploch, a Georgia-based dermatologist, told HuffPost. “They often attribute it to a previous sunburn or oral contraceptive pills. Many people aren’t aware that it is treatable.”

So what should you do if you suspect you’ve got it? Read on for more info: 

What causes melasma?

While it’s not entirely clear, researchers suspect sun exposure is the main cause: Ultraviolet light can put the skin’s color-producing cells into overdrive for some people, especially those with darker skin, according to the AAD. Hormonal changes from pregnancy or birth control can cause melasma to act up, too.

Melasma commonly appears during pregnancy, while taking birth control, or after sun exposure. 

How do I know if I have it?

Melasma patches can be subtle and come with no other symptoms. Dermatologists can usually diagnose it just by looking at the skin.

Look for brown or brownish-gray patches on your cheeks, forehead, nose bridge, above your upper lip or on your chin. Some people get patches on their forearms or neck, per the AAD.

Melasma is sometimes mistaken for more typical sun spots, or lentigos, said Jessica Krant, a dermatologist at the Laser and Skin Surgery Center of New York.

“Since there are many types of brownish skin discoloration, it’s very possible people might have some areas of melasma without realizing it,” she told HuffPost.

Does melasma put me at risk for other disorders?

No, but it may signify other potential issues. Because melasma often appears after significant sun exposure, it could mean you’re at higher risk for skin cancer, Ploch said.

Hormone changes from thyroid problems may also cause melasma, she added, so it’s smart to check with your doctor if the condition doesn’t go away.

What can I do to treat it? 

The best thing to do is start using sunscreen ASAP.

“[You] should immediately start wearing a physical sunblock daily,” Ploch said. “Melasma is easier to treat when it’s new.”

Very early melasma can clear up on its own with sunscreen, she added. If that doesn’t work, Ploch usually prescribes a compounded topical cream, then moves on to laser treatments and peels. Pregnancy-induced melasma usually clears up on its own. A dermatologist can help you plan for how treat yours.

Overall, it’s important for people to recognize that melasma is an issue, and that it’s treatable, said Anand Ganesan, a melasma expert at the University of California Irvine. Some research has shown that melasma spots can make patients feel frustrated, embarrassed or depressed about their appearance, and treating it ― instead of letting it linger ― can provide an important confidence boost, he said.

“There are situations where (melasma) doesn’t adversely affect some people,” Ganesan said. “However [that] shouldn’t be used to discount the fact that others have it and it affects them severely.” 

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Before You Go

The Skincare Routine of 5 Top Dermatologists
The One Who Loves Drugstore Cleansers(01 of05)
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Ranella Hirsch, a board-certified dermatologist in Boston

Her skin issue: Dryness. "I have really sensitive skin, and I'm just getting back into using a retinoid because this is the first time in 10 years I haven't been pregnant, trying to get pregnant or nursing," says Hirsch. (Experts recommend avoiding vitamin A derivatives like retinoid and tretinoins during pregnancy and nursing.) "I'm only using it every third night right now, and I'm peeling like crazy." That means her medicine cabinet is filled with ultra-hydrating products to help counteract that dryness and irritation. "You don't need a ton of stuff, but I probably play around with different products more than other people do."

Her Routine

Morning
1. Hirsch cleanses with a basic cleanser, "usually something you can find at the drugstore" she says. The three in her rotation right now: Neutrogena Fresh Foaming Cleanser, First Aid Beauty Face Cleanser and Dove Beauty Bar Sensitive Skin.

2. She applies sunscreen, and, yes, she really does use it every day. "My skin is basically translucent," she says, so she only uses products with SPF 30 or greater. Her three favorite sunscreens: Shiseido Ultimate Protection Lotion WetForce for Sensitive Skin and Children, EltaMD UV Clear Broad-Spectrum SPF 46 (she likes to mix this untinted sunscreen into her BB cream for protection and coverage) and La Roche-Posay Anthelios 60 Ultra Light Sunscreen Fluid. She also frequently borrows Babo Botanicals Nutri-Soothe SPF 15 Lip Treatment from the diaper bag.

Night
1. She cleanses again, usually with the same cleanser she used that morning.

2. Every third night, she applies a prescription retinoid called Refissa ("the gentlest retinoid you can get," she says) to address aging-skin concerns like fine lines and pigmentation. But every night, she puts on a double dose of skin soothers: first, Skinceuticals Hydrating B5 Gel, then First Aid Beauty Ultra Repair Cream. "When I finish up the Repair Cream, I'm going to swap it for Fresh Elixir Ancien," she says, a hydrating face oil that also minimizes wrinkles.

Extras
"Every now and then, if I'm feeling motivated, I'll use a moisturizing mask or an eye treatment like Shiseido Benefiance WrinkleResist24 Pure Retinol Express Smoothing Eye Mask," she says. Or she'll apply a bit of Peter Thomas Roth Oilless Oil Purified Squalene Treatment, another, you guessed it, hydrator.

(credit:Photo: Courtesy of Ranella Hirsch)
The One Who Can Relate to Your Breakouts(02 of05)
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Angela Lamb, MD, an associate professor of dermatology at Mt. Sinai Medical Center in New York

Her skin issue: Oil, which leaves her with blemishes. "I use acne products twice a day," Lamb says. "On the upside, people with oily skin also tend to look younger." (Gotta love that positive attitude.) That being said, she's starting to notice the signs of time on her face, so anti-aging products are now a priority.

Her Routine

Morning
1. Lamb starts by cleansing with La Roche-Posay EffaClar Gel Purifying Foaming Gel Cleanser or M-61 Power Cleanse.

2. After applying a prescription acne medication, she uses either La Roche-Posay Effaclar Mat Oil-Free Mattifying Moisturizer ("when I'm feeling really oily") or Dermalogica Intensive Moisture Balance. If her skin seems dry in the a.m., she'll switch to a heavier moisturizer, like SkinCeuticals Emollience. Here's what's not in her daily morning routine: sunscreen. (Try to contain your horror). "The only time I'm outside during the day is early in the morning when I walk to work, so I get very minimal sun exposure," she says. Plus, "I'm a darker-skinned black woman, so I don't feel as wedded to the sunscreen recommendations that I make to patients who don't have my complexion."

Night
1. She washes with the same cleanser, but this time, she uses a Clarisonic Mia brush to really get the grime of the day out of her skin.

2. Lamb applies a pea-sized amount of a topical prescription retinoid to her face, which targets both wrinkles and acne. "I always follow that up with one of the thicker moisturizers from my morning routine, either the Dermalogica or the Skinceuticals," she says.

3. In the past year, Lamb has started noticing unwelcome changes around her eyes. "I've been getting Botox on my forehead and around my eyes every six months for the past 10 years, but that doesn't help with under-eye bags, which is what I'm seeing in the mirror now." Eye cream has become a part of her daily routine—her favorite is RéVive Moisturizing Renewal Eye Cream, though sometimes she'll do an eye mask like Sisley Eye Contour Mask instead. "You want something with good moisturizers, so it can plump up the area under the eye and reduce the appearance of bags."

Extras
A couple of times a week, Lamb will use the M-61 Fast Blast 2-Minute Vitamin C Facial Mask in the shower, and occasionally she'll also use her Clarisonic to exfoliate with Dermalogica Daily Microfoliant. Both help give her skin a little glow, she says.
(credit:Photo: Courtesy of Angela Lamb)
The One With the Minimalist Routine(03 of05)
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Elizabeth Tanzi, MD, a clinical associate professor of dermatology at George Washington University School of Medicine, and the founder and director of Capital Laser and Skin Care in Chevy Chase, Maryland

Her skin issue: Rosacea, which means her skin "gets red, sensitive and breaks out sometimes," she says. Gentle anti-inflammatory products help keep it under control.

Her Routine

Morning
1. Tanzi uses the same cleanser she's used for 15 years—Donell Cream Wash. "It's gentle enough for patients to use after laser procedures, so it's great for my sensitive skin."

2. "I follow up my cleanser with a little antioxidant serum, SkinCeuticals C E Ferulic," she says. "It's anti-inflammatory, and it also layers well under sunscreen."

3. Makeup with built-in sunscreen is the last thing Tanzi applies before she walks out the door. Specifically, Colorscience Sunforgettable Brush-on Sunscreen SPF 30. "It goes on like a pressed powder, has a little color to it and you can touch it up throughout the day," she says. "I put one in every bag I own."

Night
1. She washes with Donell Cream Wash again, then applies an eye cream with peptides to promote collagen production and smooth out wrinkles (her go-to is Alastin Restorative Eye Treatment).

2. Next comes the anti-aging treatment. "I'm a big proponent of layering a retinol under a glycolic acid product, or doing them on alternate nights if your skin can't handle retinol every night," says Tanzi. She chooses to layer them. Her retinol product is iS Clinical Pro-Heal Serum Advance+, "just a couple of drops for the whole face." Finally, her moisturizer, Epionce Renewal Facial Cream, has glycolic acid to lessen fine lines and wrinkles.
(credit:Photo: Courtesy of Elizabeth Tanzi)
The One Who's All About Anti-Aging(04 of05)
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Anne Chapas, MD, the founder and medical director of Union Square Laser Dermatology in New York

Her skin issue: Minimizing the signs of aging. In addition to consistent sunscreen use and topical retinoids, "I've had noninvasive radiofrequency tightening treatments and dermal fillers regularly over the last few years to address concerns like eye bags and sagging skin," says Chapas. "I also really like laser resurfacing, which removes damaged skin cells and replaces them with new ones."

Her Routine

Morning
1. After she gets out of the shower, Chapas applies Neocutis Micro Firm Neck & Décolleté Rejuvenating Complex to her neck and chest to firm the area and reduce the appearance of "dreaded neck lines," she says.

2. Next, she washes her face with a mild cleanser like Cetaphil Gentle Skin Cleanser, then uses antioxidant-rich SkinCeuticals C E Ferulic, "which not only provides some SPF," she says, "but it also helps undo sun damage like discoloration."

3. She follows up that serum with Restorsea Renormalizing Serum, which exfoliates to help even out pigmentation, and tops it all with SkinCeuticals Blemish + Age Defense on her T-zone to unclog and minimize pores.

4. At some point before she leaves the house, Chapas also puts on EltaMD UV Clear Broad-Spectrum Sunscreen SPF 46. "It can go anywhere in the routine because physically blocking sunscreens, like this one, don't have to be absorbed into the skin to be effective," she says.

Night
1. After washing her face with Cetaphil again, Chapas applies SkinMedica Retinol Complex 0.5 to reduce fine lines and even out skin tone.

2. The morning's chest-and-neck cream gets a second use, this time as Chapas's nightly moisturizer.
(credit:Photo: Courtesy of Anne Chapas)
The One Who's Serious About Makeup Removal(05 of05)
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Jessica Wu, MD, a clinical assistant professor of dermatology at University of Southern California Keck School of Medicine

Her skin issue: Eczema, which means she's careful about using overly drying products or cleansers that might strip the natural oils off her skin, which can lead to flare-ups.

Her Routine

Morning
1. "I don't always cleanse in the morning," says Wu. "Usually I just splash my face with lukewarm water in the shower, but if I'm feeling oily, I'll wash with Bioderma Micellar Water."

2. Next, Wu uses Robin McGraw Revelation OMG Is This Really Me Serum [disclosure: Wu recently became the chief medical advisor for Robin McGraw Revelation], which she applies anywhere she's starting to notice crepey-ness and fine lines—under the eyes, on the smile lines and the upper lip, in particular.

3. Sunscreen isn't an everyday must for Wu, because "I leave for the office before the sun is up and I'm there until 7 p.m." But on the weekends, she uses the Vichy Ideal Soleil Stick SPF 50+. "It's waterproof and doesn't budge," she says.

Night
1. Wu wears foundation and eye makeup daily, so the first thing she does at night is use the Bioderma Micellar Water to take everything off. "I get five round cotton pads, soak them with the water, then use the first two to take off my eye makeup, then the third and fourth to take off the rest of my makeup, and I use the fifth pad as a toner. It leaves my skin soft and clean but not stripped," she says.

2. On Mondays, Wednesdays, and Fridays, Wu applies a thin layer of a prescription tretinoin called Renova. "It stimulates collagen production and helps control my oil and monthly hormonal breakouts," she says.

Extras
Once a week, Wu does a deeper cleanse using Cerave Hydrating Cleanser and a konjac sponge like the Boscia Cleansing Sponge. "You can also find them at your local Asian food store for about $2," she says. Then, every two to three weeks, if her skin is really dry or she feels an eczema flare coming on, she'll apply the hydrating SK-II Facial Treatment Mask.
(credit:Photo: Courtesy of Jessica Wu)

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