Category Archives: Melasma

What is the “Mask of Pregnancy?”

Many women get melasma, a common skin problem characterized by brown to grey-brown patches on the face and other parts of the body that get lots of sun. The condition is far more common in women, and it often accompanies pregnancy. Because of this connection it is casually known as “the mask of pregnancy.”

Who gets melasma?

Melasma is mostly an issue for women, as only 10% of those who get the condition are men.

It tends to affect people with darker skin tones and there seems to be a genetic element. If you’ve had a blood relative with melasma, you’re far more likely to get it as well.

What causes melasma?

As with other skin conditions such as rosacea, there isn’t a direct cause/effect relationship with melasma. The condition is likely the result of the melanocytes — the skin cells responsible for pigment — overproducing color. That’s why it is believed that people who already have more pigment in their skin are more prone to melasma because their melanocytes are more active than people with fair skin.

There are certain triggers for the dark facial pigmentation of melasma:

  • Hormonal changes— Pregnant women often get melasma due to the extreme changes in their hormones. In a similar fashion, birth control pills and hormone replacement medicines can trigger melasma.
  • Sun exposure— The ultraviolet light from the sun triggers the melanocytes in the exposed skin to produce pigment as a safety mechanism. This is why human skin tans. Once a person with melasma is exposed to some sun, an area that has faded will often become darker again. Because of this, more cases of melasma occur during the summer.
  • Cosmetics— Certain cosmetics can worsen melasma if they irritate the skin.

Signs of melasma

Melasma isn’t a health-impairing condition; its effect is purely visual. Melasma shows itself in brown or grey-brown patches on the skin’s surface.

These are the most common areas:

  • Forehead
  • Cheeks
  • Above the upper lip
  • Chin
  • Bridge of the nose
  • Forearms and neck (less common)

How we treat melasma

Melasma often fades on its own, especially if the patient protects herself from sun exposure. Other triggers such as hormonal fluctuations during pregnancy resolve themselves after delivery or the trigger is removed.

Sometimes, however, the condition persists. Or, if birth control pills were responsible, the woman may want to continue to use them. Then we have various treatment options at the Center for Dermatology and Laser Surgery.

  • Hydroquinone— We use prescription-strength hydroquinone usually as a first option. When applied to the darkened areas, it lightens the skin.
  • Tretinoin and corticosteroids— Beyond hydroquinone, these are the next two steps in enhance skin lightening. Sometimes we will use a cream with all three medicines (hydroquinone, tretinoin, and corticosteroid).
  • Other topical medicines— Azelaic acid and kojic acid also lighten the skin.
  • Procedures— If topical applications don’t seem to be generating the results you seek, we can opt for chemical peels (usually glycolic peels), microdermabrasion, or dermabrasion.

Melasma can be stubborn to eliminate, and it may recur. Sticking with the treatment plan we create is important.

If you have the signs of melasma, call us the Center for Dermatology and Laser Surgery, (503) 297-3440, and let’s take a look.


Today’s Top Solutions for Managing Melasma

For countless individuals, melasma is a daily reality.  Characterized by areas of skin discoloration – particularly on the face – melasma can take its toll not only on a patient’s appearance, but also their self-esteem.    Emphasizing the condition’s far-reaching effects, Portland Dermatologist, Dr. Beata Rydzik, explains how patients can fight back in the battle against skin discoloration.

“Melasma is a common skin condition, which usually presents as brown patches on the face, at times extending to the neck,” states Dr. Rydzik.  “While often not a medical concern, it can play a distressing role on individual’s confidence and sense of self worth.  The cause of melasma is not yet fully understood. It likely involves a complex interplay between melanocytes and UV light. For reasons not yet clear melanocytes which are the color producing cells in our skin end up producing too much pigment,” comments Dr. Rydzik.

When asked to explain who may be at risk for developing the condition, Dr. Rydzik offered this:  “While melasma can affect nearly anyone, we see it more in female patients, especially those on oral contraceptive pills or those who are pregnant.”  Dr. Rydzik’s assertion confirms data published by the AAD, which explains that, “Just 10% of people who get melasma are men.”

“What is important for patients to understand is that melasma can be managed.  The first step is identifying and minimizing triggers such as overexposure to the sun or oral contraceptive pills. The appearance of existing brown spots can be diminished. This can often be accomplished by some combination of topical medications and cosmetic procedures followed by intense sun protection” states Dr. Rydzik.  “Popular treatments include creams such as Hydroquinone and Tretinoin, usually available at your dermatologist’s office or at the pharmacy. Depending on the type of melasma, chemical peels and some laser procedures can be safe and effective.”

Speaking on how patients can take a “first step” in managing their melasma, Dr. Rydzik concluded with this:  “While dealing with melasma can sometimes feel like an uphill battle, understand that you do not have to take the journey alone.  I encourage anyone dealing with melasma to first consult with a board certified dermatologist in their area and learn more about getting a handle on their symptoms.”

Interested in Learning More About Melasma? Contact the Center for Dermatology and Laser Surgery.

For more information about melasma and its treatments, contact the Center for Dermatology and Laser Surgery. We are located in Portland and can be reached directly at 503.297.3440. We look forward to hearing from you soon.


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