Melasma on the face is primarily caused by hormonal changes, often exacerbated by sun exposure.
Understanding Melasma
Melasma is a common skin condition characterized by brown or gray-brown patches, typically on the face. It's most prevalent in women, especially during pregnancy or when taking hormonal birth control.
Key Contributing Factors
- Hormonal Changes: Fluctuations in estrogen and progesterone levels play a significant role. Pregnancy, hormone replacement therapy, and oral contraceptives can trigger or worsen melasma. The reference specifically mentions the link between oral contraceptives and melasma.
- Sun Exposure: Ultraviolet (UV) radiation from the sun stimulates melanocytes (pigment-producing cells) to produce more melanin, darkening the affected areas.
- Genetics: A family history of melasma increases your susceptibility.
- Skin Type: Individuals with darker skin tones are more prone to developing melasma.
- Other Potential Triggers: Certain skincare products or medications may contribute, though this is less common.
The Process
Hormonal changes sensitize the skin, making it more susceptible to the effects of UV radiation. When exposed to sunlight, the melanocytes become overactive, leading to the characteristic patches of hyperpigmentation.
Management and Treatment
While there is no cure for melasma, various treatments can help lighten the patches and manage the condition:
- Sun Protection: Daily use of broad-spectrum sunscreen with a high SPF (30 or higher) is crucial. Reapply every two hours, especially when outdoors.
- Topical Medications: Common treatments include hydroquinone, retinoids, corticosteroids, azelaic acid, and kojic acid. These work by inhibiting melanin production or promoting skin cell turnover.
- Procedures: Chemical peels, microdermabrasion, and laser therapy can be used to reduce the appearance of melasma, but should be performed with caution by a qualified dermatologist.
- Oral Medications: In some cases, tranexamic acid may be prescribed orally, but this is usually reserved for more severe or resistant cases.
Example
Imagine a woman starting oral contraceptives. The increased estrogen levels make her skin more sensitive to sun exposure. If she doesn't consistently use sunscreen, she's more likely to develop melasma, particularly on her forehead, cheeks, and upper lip.
