3 Key Facts and Myths About Melasma

By Hirshel Kahn, MD

Here’s an undeniable fact about melasma: No one wants the stubborn skin condition, which shows up as brown, tan or grayish skin patches on the cheeks, nose or jawline. However, many myths exist about its treatment.

Affecting about 6 million people in the United States, melasma disproportionately strikes women between the ages of 20 and 50, according to the American Academy of Dermatology. The increased facial pigmentation is also more common in those with darker skin and influenced by factors such as sun exposure, hormones and genetics.

Melasma is often called the “mask of pregnancy” since it’s even more prevalent in women who are expecting, likely due to a surge in hormones. Beyond the basics, however, many people are misinformed about how melasma can best be tackled and what to expect down the line.

What you should know 

What are some of the most common myths about melasma – and what’s the truth? Here are three of the top examples:

Myth: Melasma is Permanent

Fact: Melasma is Treatable and Beatable

Highly visible, melasma patches can cause a lot of embarrassment and self-consciousness among those affected. But the fear that melasma is permanent once it strikes is simply wrong. Especially when the trigger for melasma is something that comes to an end – whether pregnancy, excessive sun exposure, or oral contraceptive use – melasma can go away on its own over a long period. If you don’t want to wait and see, active treatments to beat melasma include:

Hydroquinone: Available in cream, lotion, gel or liquid form, hydroquinone tends to be more effective in prescription-strength versions but is also sold over the counter.

Tretinoin and corticosteroids: These ingredients are often prescribed as a second medication to enhance the effects of hydroquinone. Some versions include hydroquinone in what’s called a “triple cream.”

Other topical medications: These skin-lighteners include azelaic acid or kojic acid.

In-office procedures: If topical treatments don’t get rid of melasma, dermatologic treatments include chemical peels, microdermabrasion or dermabrasion procedures to carefully slough off layers of skin.

Myth: You Can Scrub Melasma Away

Fact: Scrubbing Can Make Melasma Worse

While sloughing off top layers of skin in office-based procedures can lighten melasma patches, some people think that scrubbing skin repeatedly at home will accomplish the same thing. Unfortunately, however, being overly aggressive with these efforts can actually worsen melasma by irritating the skin, leading to more pigment being produced and extra darkness. Scrubbing too vigorously may seem like the right approach, but it can backfire/

Myth: One Melasma Treatment is Enough

Fact: Ongoing Treatments Often Necessary

A once-and-done mindset to melasma is also a common misconception. The fact is, melasma often recurs even after being eliminated or being successfully treated.

Unfortunately, melasma may not be gone for good despite diligent efforts. That’s why prevention is the best approach to keep it at bay.”

Prevention tactics for melasma include:

Sunscreen use: Using a broad-spectrum sunscreen daily with an SPF of 30 or higher is imperative, since the main risk factor for melasma is sun exposure.

Hats: Donning a wide-brimmed hat when outdoors also combats excessive sun exposure on the face.

Gentle skin care: Facial cleansers that sting, burn or irritate are a bad idea, since they can worsen melasma.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.

Hirshel Kahn, M.D., is board certified and specializes in dermatology and dermatopathology at Advanced Dermatology P.C.