Fluctuating hormones can lead to a skin condition called chloasma which is also referred to as melasma. It is a common problem among women who are pregnant. This condition is so closely linked with pregnancy that it’s sometimes called the “mask of pregnancy.” It’s referred to as a mask because of the patchy areas of discoloration it produces. These discolored areas are due to increased production of melanin, the pigment that gives skin and hair its color. It’s most common in areas that are exposed to sunlight, especially the face.
Chloasma is closely linked with pregnancy and fluctuations in hormones, but you don’t have to be pregnant or even a female to get it. Men can get it too, although less frequently. Women who are on birth control pills or hormone replacement therapy are more prone to this skin condition. Sun exposure plays a role since it’s most likely to affect areas exposed to sunlight like the face. Genetics are also a factor in determining who will acquire the condition.
In some cases, the patchy areas of pigmentation disappear after the baby is delivered or after stopping birth control pills or hormone replacement therapy, but the changes can also be persistent in some women and take years to fully resolve. Not surprisingly, most women don’t want to wait that long. Fortunately, there are treatments that can help.
Sun protection is critical for treating chloasma since sunlight seems to play a role in triggering it. Use a sunscreen that protects against both UVA and UVB rays that can damage skin and increase melanin production. UVA rays can penetrate glass, so it’s important to wear it indoors and outdoors along with protective clothing and a hat.
One of the most reliable treatments for chloasma is a chemical called hydroquinone. It works by blocking the production of melanin. It also helps to lighten existing pigmented areas while preventing the formation of new ones. Another ingredient called kojic acid works in a manner similar to hydroquinone, by blocking melanin production. Both ingredients are proven to lighten pigmented skin, and they work even better when combined with glycolic acid, a weak acid that gently sloughs off the outer layer of dead skin cells. This sloughing action helps hydroquinone or kojic acid penetrate better, which makes them more effective for lightening areas of pigmentation.
Some products contain hydroquinone in combination with glycolic acid to maximize its pigment-lightening effect. Others contain kojic acid combined with glycolic acid in a hydroquinone-free formulations in order to lift and lighten darkly pigmented areas. Glycolic acid also improves the texture of skin, causing it to feel smoother and reflect light better.
Prescription-strength retinoids help to fade pigmented areas due to chloasma, but it can take 6 months or more to see improvement. Retinoids are also cause redness and skin irritation, which some people can’t tolerate. Another treatment that works in some cases is a series of facial peels using weak acids. Dermatologists do these treatments in their office, but it takes more than one peel to get visible lightening, and the treatments can be expensive.
Please note that many of the treatments mentioned contain ingredients that are not pregnancy-safe, and should only be used post-pregnancy.
Chloasma is a challenging condition to treat, but hydroquinone or kojic acid combined with glycolic acid can lighten areas of pigmentation over time. These ingredients are also effective for treating age spots, liver spots and freckles. The key is to use these ingredients consistently along with adequate sun protection to prevent further melanin production and skin darkening.