Maybe you saw new spots appear on your face last summer. These cover your cheeks, or perhaps your forehead, or they may be on your upper lip area. In such a case you probably suffer from melasma, which I have already told you about in another article.
It is likely that just this summer you were pregnant (“pregnancy cloth”) or on oral contraceptives. Melasma tends to appear more frequently in these cases, but don’t be surprised if it did not. Many girls get these spots for no reason at all. Often we do not find a clear cause, although it seems that estrogens (female hormones) have something to do with it, since this type of spots occur mainly in women.
It is also known that the sun is clearly involved, as spots tend to worsen after exposure to the sun, especially in summer. We have already talked on other occasions about the different radiations emitted by the sun and that sunscreens are mainly effective against UV rays. It seems, however, that other radiations such as infrared or visible light may also be involved in melasma, and blue light in particular is known to be more damaging in brown people. Therefore, even if you use the best sunscreen in a perfect way, it may not be enough to prevent the appearance of melasma.
The reality is that melasma is very difficult to treat; but we can improve it. Normally, those who have melasma will always have a tendency for certain areas of the skin to darken, but we can find ways to attenuate it and avoid/reduce its appearance. Winter is the time to lighten it and in spring-summer we have to do our best to prevent it. Here are the keys.
1. SUN PROTECTION:
This is most important, especially in spring and summer. Remember that sun protection does not mean just sun “cream”, but avoiding the radiation coming from the sun in the best way we know how. A good sunscreen with SPF 50+ will avoid more than 98% of UVB radiation, and part of UVA, infrared and visible light…but not all! Tinted sunscreens block visible light, and are advisable in persons with melasma.
Photoprotection is not only sunscreen; complement it with a hat and umbrella.
Always keep this in mind. It is important to complement topical photoprotection with other means: avoid the central hours, wear a hat or cap or use an umbrella.
The more you minimize the sun’s incidence on your face, the less likely it is that melasma will be accentuated when summer arrives.
2. BLEACHING PRODUCTS:
The star depigmenting agent is hydroquinone. It is the most potent product available, which we usually use in concentrations of 2-4% and can be used alone or in combination with others.
Hydroquinone is the most effective depigmenting agent, alone or in combination with other products.
In addition, we can also use azelaic acid, kojic acid, retinoids, hydroxy acids or even topical corticosteroids. We usually use combinations of these elements. It is best that your dermatologist assesses what is best suited to your case, depending on the sensitivity of your skin or its color.
3. ORAL TREATMENTS:
Tranexamic acid has recently been found to be useful in improving or preventing melasma. It is a drug that some girls use to reduce menstrual bleeding. At lower doses, it has been found to prevent sun-induced skin pigmentation.
Tranexamic acid is a novel treatment for melasma
4. OTHERS:
Lasers, pulsed light and peelings are excellent aesthetic techniques that help us for a lot of aesthetic treatments (scars, certain spots, hair removal, wrinkles, veins) but in the case of melasma, we limit their use to specific cases in which the above does not work, because their effectiveness is usually not so high.
Lasers or peels may be useful in some cases.
In conclusion…
∼Melasma is difficult to treat, but fortunately we have several treatment options with which to keep it at bay, first to lighten it and on the other hand, and not least, to prevent it.
∼Get advice from your dermatologist who will recommend the best option for you. Not all skins are suited to the same thing.
