FREQUENTLY ASKED QUESTIONS ABOUT MELASMA: answered by Dr. Carolina Vera
- What is melasma and what causes it when you’re pregnant?
Melasma is a chronic acquired hypermelanosis (darkening) of the skin, characterized by irregular brown macules symmetrically distributed on sun-exposed areas of the body, particularly on the face. It affects mainly women and is more prevalent in darker pigmented individuals (Fitzpatrick skin types III-V).
During pregnancy, the hormonal changes, particularly increased levels of estrogen, progesterone and melanocyte stimulating hormone (MSH) lead to increased activity levels of the melanocytes, which are the pigment producing cells in our skin.
- Where does it most frequently appear on the body and when in a woman’s pregnancy?
It most frequently appears in the face thus prompting many to seek medical attention. In pregnancy it typically will appear in the second or third trimester.
- Which women are more at risk for getting melasma when they’re pregnant? Why? What percent of pregnant women get melasma?
Women of darker skin tones (Fitzpatrick skin types III-V) are at higher risk for getting melasma during pregnancy and basically it is because they have more melanocytes in their skin which when activated by pregnancy hormones will cause the skin to darken further. It’s hard to come up with a an accurate percentage because of the many skin types in the world and their exposures to different climates but it may be as high as 20% in some ethnic groups that may be affected by melasma at some point in their lives.
- If you’re at risk for getting melasma when pregnant, is there any way to prevent it?
There is no way to prevent melasma 100% since it’s cause is multifactorial but the best way to try and prevent melasma from activating is to stay out of the sun and wear a tinted sunscreen everyday.
- What are the best melasma treatment options (including the PiQo4, of course).
If a person suffers from melasma there are a few things that can be done to reverse it and control it.
The quickest way is to be treated with a pigment correcting laser, like Piqo4. Piqo4 by Lumines is effective and yet gentle enough to treat even the darkest skin types. Multiple treatments are needed to achieve complete resolution but this laser has no associated downtime.
The next treatment option is through the use of pigment correcting creams that can be either prescribed by your doctor or there are some over the counter options as well. In my office, I compound medical grade ingredients to create a very powerful cream and for maintenance I recommend Skinceuticals pigment corrector and discoloration defense.
And of course, a daily tinted sunscreen is a must as well as taking every precaution to stay out of the sun and avoid extreme temperatures like saunas, kitchens or hot yoga rooms since extreme temperatures can also trigger melasma.
- Can the treatments be done while a woman is pregnant or does she have to wait until the baby is born?
Most treatments should be avoided while pregnant but there are a few safe pigment correctors one can use while pregnant.
The most important treatment goes back to avoiding sun exposure and wearing that tinted sunscreen daily.
- Can anything be done to prevent melasma from getting worse?
To prevent melasma from getting worse one must avoid the triggers when possible (sun, hormonal changes, extreme heat and stress)
- Does melasma go away after pregnancy if you don’t treat it?
Melasma will improve on its own after pregnancy but may not completely clear. Once melasma is triggered, in the case of pregnancy, by hormones, it will tend to become a chronic condition that will need periodic treatment to keep at bay.
- Does it affect a woman emotionally?
It most certainly affects a woman emotionally. Since it most often affects the face, it may affect ones self esteem and how one views themselves. It is often for this reason woman suffering from melasma seek medical attention.
- Are some cases much worse than others when a woman is pregnant?
The degree of melasma is definitely varied. While some women may only notice light brown patches here and there others may suffer from extremely dark patches affecting most of their face.