What is Melasma?
While best known as the “mask of pregnancy”, melasma literally means dark skin. It commonly affects the apples of the cheeks, the mid forehead, jaw line and areas around the mouth. Hyperactive pigment cells in skin are to blame. These pigment producing cells become stimulated to produce extra unwanted pigment resulting in patchy discoloration. Triggers include estrogen supplements, birth control pills, pregnancy and sun exposure. You don’t have to be pregnant (or even a woman) to develop melasma. And if you think you’re silently suffering alone, think again, an estimated six million women throughout the U.S. are currently affected by this distressing condition.
Do I need to stop the pill?
Certainly it seems that some women simply cannot avoid developing melasma when on oral estrogens. However, experiencing melasma does not automatically dictate having to discontinue the pill. Highly effective melasma therapy and a well thought out maintenance plan to prevent recurrences are your best approach.
How much does sun exposure matter?
All the estrogen in the world won’t give you melasma if you don’t have some sun exposure. Sunlight dramatically darkens pale pools of pigment with as little as a drive in the car. The single most important first step in preventing melasma is avoid sun exposure at all costs! This means visible light, UVA and UVB. You must apply a true broad spectrum greater than SPF 30 multiple times a day.
The best type of sunscreens for melasma patients include a physical block like titanium dioxide or zinc oxide sunscreen. Newer formulations that have micronizing technology make these types much easier to use than they used to be. Dr. Jennifer Janiga is a firm believer in these physical blockers for melasma.
In addition a wide brimmed hat of greater than 3 inches will help protect your face from the sun. Wear your favorite extra-large sunglasses (think Greta Garbo). Then minimize your sun exposure, especially during the hours of 10-4.
What is the Melasma treatment?
In addition to sun protection, melasma treatment can include bleaching creams, which are commonly prescribed by Dr. Jennifer Janiga. Many bleaching creams are available alone or in combinations. The most popular bleaching medication is hydroquinone; it comes in over the counter strengths, 1-2% or prescription strength of 4-12%. Hydroquinone cannot be used in pregnancy or while nursing.
Other prescription medications that help the bleaching process are tretinoin, azeleic acid, and topical steroids. Talk to Dr. Jennifer Janiga to see if any of these medications alone or in combination are right for you.
There are some over the counter preparations with mild amounts of hydroquinone, kojic acid, glycolic acid, salicylic acid, and retinol that can be tried prior to an appointment with Dr. Jennifer Janiga.
Do you see patients for Melasma treatment and evaluation in your Reno office?
Yes. We evaluate and treat patients who are concerned about melasma. Initial appointment length varies and depends on severity of condition, outward signs and other contributing factors, but is usually not more than 15 minutes in duration.
For more information, or to set up a consultation with Dr. Jennifer Janiga for melasma evaluation and treatment in our Reno/Tahoe dermatology office, please send us an email or call 775-398-4600.