Living with melasma — those dark patches on your face — is an ongoing struggle, but summer seems to have kicked it into high gear. Now that we’re heading into fall, you’re wondering if your skin will calm down and your blotches will fade with the sun.
Dr. Robert Topham and our Holladay Dermatology & Aesthetics team see an uptick in melasma cases every summer because exposure to ultraviolet rays exacerbates the condition. If your melasma patches worsened over the last few months, here’s what you need to know about what you can expect this fall and winter.
If you have melasma, you already know it’s a form of hyperpigmentation that creates dark skin patches on your face and maybe even your arms, hands, neck, and chest. But do you know the difference between melasma and other forms of hyperpigmentation?
Melasma occurs when your skin’s pigment cells (melanocytes) become hyperactive. Researchers have pinpointed a few reasons for this phenomenon and have some working theories, but they’re still searching for a definitive cause.
We know that hormone fluctuations can trigger melasma, which is why many mothers-to-be develop “the mask of pregnancy.” Some medications, like birth control pills, anti-seizure medications, and antibiotics, can also excite melanocytes and lead to melasma. Some experts also believe that stress can incite melasma by triggering a flood of the hormone cortisol.
However, sun exposure is the primary culprit. When the sun’s ultraviolet rays hit your skin, your body cranks up its melanin production to protect the tissues from damage. In some people, these overactive melanocytes gather together, creating blotchy dark patches.
Sun damage is another form of hyperpigmentation, but it differs from melasma in a few key aspects. While the sun plays a role in both conditions, hormone fluctuations, medications, and stress can’t cause sun damage.
Sun damage only occurs due to sun exposure, and it begins long before you notice it. Every time the sun hits your skin, melanocytes jump into action. Too much time in the sun overwhelms their ability to protect your skin, so you burn. Moderate time in the sun results in a “nice tan,” which is actually your melanocytes banding together to block out the sun’s UV rays.
Even if you don’t burn or tan, your cells know when the sun is out, and the effects are cumulative, meaning that every time you’ve exposed your skin to the sun since you were a child adds up in your tissues. Eventually, the melanocytes form spots on your skin, like freckles or large dots, unlike the regional melasma patches.
As its name suggests, sun damage destroys your skin’s structure, whereas melasma is simply a cosmetic issue. In addition to spots, sun damage can lead to wrinkling, decreased skin elasticity, broken capillaries, and skin cancer.
Whether hormones, medication, stress, or genetics caused your melasma, one thing is true — the sun exacerbates it. The good news is that once the sun fades, so does your melasma.
Just because your melasma fades with the sun’s waning intensity doesn’t mean your melasma is gone. Since melasma is a chronic skin condition, it lurks under the surface, ready to appear again under the right circumstances, like a sunny day on the winter slopes or a hot, steamy bath.
Everyone should protect their skin from excess sun exposure, but if you have melasma, it’s non-negotiable. Dr. Topham recommends a broad-spectrum sunscreen for all our melasma patients — every day, every season. Even on cloudy days, when you can’t see the sun, its UV rays still break through the atmosphere and penetrate your skin.
Although the change of season may reduce the appearance of your dark patches, you may find that melasma sticks with you this fall. If so, we can help.
Depending on the severity of your melasma and your personal preferences, Dr. Topham can treat your melasma with topical medications, such as hydroquinone, tretinoin, retinoids, or acids such as azelaic, kojic, or glycolic.
We also offer PICO Genesis™ laser treatment, which painlessly targets the clumped melanocytes and breaks them into tiny pieces so your body can flush them away.
To discover which treatment is best for your melasma, contact us in Holladay, Utah, at 801-272-4408.
