With the summer upon us, the barbecues, beach parties, and outdoor events begin populating our calendars. Our time at the beach increases exponentially if you’re another sun-lover. But have you started seeing patches of darker or blotchy skin appear on your face and neck? 

If your answer to the above is yes, then you may have developed melasma. Read on to find out if you do indeed have melasma and what melasma treatments are available. We will also explore what you can do to prevent it from getting any worse.

What Is Melasma?

Melasma is patchy, brown hyperpigmentation on the face and neck (and sometimes the chest and arms). It is more common in females, people with darker skin tones (people of African, Asian, Indian, Middle Eastern, Mediterranean, or Latin American descent all have the highest chances of developing melasma), and it can run in families. Unlike chronic hyperpigmentation from the harsh Australian and New Zealand sun, which appears as random spots or freckles, melasma often presents in symmetrical patterns. It appears on different areas of the face, including the forehead, eyebrows, cheeks, chin, nasolabial folds, upper lip, earlobes or medial canthal lines. 

What Causes Melasma?

• Sun exposure: This is the main reason that people develop hyperpigmentation resulting from melanocyte stimulation.
• Melanocytes: The cells in the skin and eyes responsible for producing melanin. High concentrations or hyper-activation creates patches of darker skin.
• Hormonal changes: Melanocytes can misbehave under the presence of hormonal changes or imbalances, including thyroid dysfunction. Similarly, menopause, birth control pills, and cosmetics affecting estrogen and progesterone have been linked to this condition. Genetics play a big role, out of all cases around 50% can be attributed to genetic history.
• Pregnancy: Sometimes called the ‘mask of pregnancy’, melasma can develop due to the hormonal changes brought about by pregnancy. 
• Contributing diseases: Hyperpigmentation can be caused diseases such as Addison’s, hemochromatosis, and lentigines.

Melasma Treatment

Melasma treatments include brightening and fading active ingredients, hydroquinone, topical retinoids, and chemical peels. In addition, certain in-clinic laser, and light therapies have been shown to be safe and effective treatments, all of which can continue through the summer months as long as sun exposure is minimised.

• Laser Treatment: While lasers can be used to melasma in some cases, it should be used with extreme caution to prevent post-inflammatory pigmentation (a darkening of the skin). Laser treatment should be considered using very low setting Q-switched Nd:YAG lasers or fractional lasers.
• Chemical Peels: Glycolic and azelaic acid peels are commonly used to treat melasma. Azelaic acid reduces has anti-melanin properties that act on hyperactive melanocytes.
• Light Therapy: Heat from intense-pulsed light (IPL) is used to remove pigment. However, the heat can sometimes result in post-inflammatory hyperpigmentation and a potential relapse within three months. Consult your doctor and dermatologist before taking this route.
• Prescription Only Compounded Creams & Serums: Telehealth skin care providers are creating personalised treatments for their patients based on their lifestyles, and current skincare routines. A discovery questionnaire is followed by an online consultation with a doctor, who will diagnose your skin concerns and help you identify any triggers in your current lifestyle. A prescription-only cream base or serum is then formulated for your needs and delivered to your door.

The Gold Standard Active Ingredients In Melasma Treatments

Azelaic Acid: The anti-melanin properties of azelaic acid, when combined with a prescription retinoid make azelaic acid a useful topical treatment for melasma and hyperpigmentation.

Hydroquinone: Hydroquinone is the gold standard treatment for pigmentation (especially melasma) when delivered under medical care, as it reduces the formation of melanin in the skin. It inhibits the tyrosinase enzyme which is responsible for melanin production. Hydroquinone is used to lighten dark areas of skin, such as freckles, age spots, melasma, and pigmentation resulting from injury to the skin. 

Tretinoin: Tretinoin is a derivative of vitamin A. It is used on the skin (topically) to treat skin damaged by excessive sun exposure. It increases the rate at which cells reach maturity and die, therefore quickly replacing the damaged cells with new and healthy ones, free of hyperpigmentation.

Corticosteroids: Some of you may already be familiar with this treatment. Typically, it is used in a variety of ways with the main effect being the reduction of inflammation and immune responses. This is often added to treatment creams to mitigate the more extreme reactions in the body.

How To Prevent Melasma Flare-Ups This Summer

What can you do to make the most of the summer sun and ensure your tan stays golden? Sunscreen is one of the most overlooked items in the beauty and skincare industry. For those who love spending time outdoors, or even if you have no choice but to work in the sun, protecting the skin from UV rays is vital.

One of the best ways to management melasma is sun avoidance, which during the summer is hard, we know. Style one of those glamorously large sun hats and pair them with a good sunscreen that contains a physical block of either zinc oxide and/or titanium oxide. Reflection from sand and water mean you need to be conscious of light from above and below, so don’t skip the sunscreen just because you are wearing a hat.

A broad-spectrum SPF of 30 and above should be your go-to product, and part of your daily skincare routine. Even if the weather is overcast, put on that sunscreen – UVA and UVB light cuts through cloud cover, and UBV penetrates water. 

To prevent melasma from occurring or reoccurring, we advise that you take extra care when it comes to sun protection, as well as staying away from any sorts of treatments that can cause hormonal imbalances.