Ah, melasma: It's arguably the world's most annoying skin ~issue~, and I can confidently say that because I've dealt with it on and off for the last seven years. Acne? Rosacea? Eczema? I'd rather deal with all three (and I have! Sometimes all at once! Lucky me!) than have to deal with melasma. Not only is melasma be caused by a zillion different things, but it's also STUBBORN. So once you get it, it doesn't just magically go away, even if you throw a ton of products at it.
The only upside to my life of brown patches? I'm now a self-proclaimed melasma expert, and I've tried virtually every treatment and product in existence. So pls allow me (and two trusted dermatologists) to tell you legit everything you need to know about getting rid of melasma, including the best brightening products and treatments to try at home and at the dermatologist's office. Finally, my skin problems have purpose.
What does melasma look like?
Unlike dark marks or post-inflammatory hyperpigmentation (which both look like small spots in concentrated areas of the face), melasma is often widespread, appearing as grayish-brown, mask-like patches on the cheeks, bridge of nose, chin, forehead, and above upper lip, explains Uchenna R. Okereke, MD, dermatologist at The Dermatology Specialists in NYC.
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Who can get melasma?
It primarily affects women (fact: 90 percent of people with melasma are female, says Dr. Okereke) in their 20s, 30s, and 40s—so really, any adult woman can get it. That said, people with darker skin tones have more active melanin-producing cells in their body (melanin, FYI, is the thing that gives color to your skin, eyes, hair, etc.), making them more prone to melasma, says Dr. Okereke. There also the genetics thing: If your mom or grandma has or had melasma, chances are you could too. Womp womp.
What is the main cause of melasma?
"Melasma happens when melanocytes—the cells that produce melanin in your skin—become overactive and produce an excessive amount of pigment," says Dr. Okereke. The overactivity can happen for any number of reasons (which is one of the reasons melasma is so hard to treat), but the two biggest causes are sun exposure and hormones, hence why you sometimes hear melasma referred to as a "sunstache" (sun!) or "pregnancy mask" (hormones!).
That means if you love to lay out, skimp on SPF, use hormonal birth control, or are pregnant, you're a prime candidate for developing melasma. Other triggers? Certain medications (so talk to your doctor), inflammation (from pollution, products, irritation, etc.), excessive heat (from things like hot yoga or hanging in the steam room), and an overly harsh or an aggressive skincare routine.
How to treat melasma at home
After years of trial and error (read: trying lots of products that either did absolutely nothing or fully sizzled my skin off), I've found that a consistent routine of brightening serum plus a thick layer of mineral SPF in the morning, along with a retinoid at night is the best way to treat melasma at home. But be warned: You don't want to overdo it since inflammation can trigger melanocytes and end up worsening your melasma, says Dr. Okereke. That means chill with the dermarollers/microneedlers and scrubs and stick to these tried-and-true products, below, instead.
It's going to do all the heavy lifting when it comes to fading your melasma. Look for one with vitamin C (ideally in the 10 to 20 percent range), tranexamic acid, kojic acid, and/or hydroquinone (which, FYI, is the most intense and potentially irritating of the brighteners, so skip if you have anything but "tough" skin). All of these suppress excess pigment production while lightening melasma and evening out your skin tone.
You can use all the brightening products in the world, but without SPF? It's pointless, since UV exposure is basically a one-way ticket to melasma town. Choose a sunscreen that's got SPF 30 (at the very least) and is made with mineral or physical blockers, like zinc oxide and/or titanium dioxide.
"Chemical sunscreens only block UV light, but zinc sunscreens block all types of light, making them more effective at preventing melasma," says dermatologist Saya Obayan, MD. And, if you want to kick the protection up a notch, choose a sunscreen that also contains iron oxides. "They help block blue light from your computer and phone," she says, "and they also give you extra UVA protection."
Retinoids are a must for melasma. They speed up your cell's turnover rate, meaning they help push those damaged, hyper-pigmented skin cells to the surface (and then slough them off) to make room for fresh, new, and undamaged skin cells. The result? Skin that's less blotchy and more even-toned skin.
There's a catch, though: Retinol can be irritating (which we know can end up making melasma worse), so start with a gentle formula and use it slowly at first: One night a week for one week, two nights a week for two weeks, three nights a week for three weeks, then every other night indefinitely. But if your skin gets red or flaky, scale back your usage again until your skin has had time to adjust.
In-office treatments for melasma
Bad news first: Skincare routines take time to work. Don't expect to slather on a bunch of products and suddenly be melasma free. Be patient with it—most routines take three to four months to yield visible results. Now for the good news: If you can't be patient and want your melasma gone ASAP (like for a wedding or special event), you can head to the derm for a chemical peel (Dr. Obayan recommends one with salicylic acid, trichloroacetic acid, or glycolic acid) or a laser treatment (like IPL or ngYAG). These treatments are on the pricey side ($300+), but are great for when you want ~dramatic~ results and fast.
The final word
Melasma can't really be "cured." It can fade on its own or in some cases it can linger for years, says Dr. Okereke. "If you're lucky enough to have your melasma clear up, it's still important to continue with maintenance therapy to prevent it from coming back." That means 1) wearing sunscreen religiously and a wide-brimmed hat or visor when you're spending time outside, 2) avoiding irritating skin care products, and 3) using a serum or topical with brightening ingredients. And, as someone who will probably be dealing with melasma to some extent for the rest of her life, trust me when I say you kinda, sorta, eventually get used to it. Silver linings?
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