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Melasma is a skin condition that is so common during pregnancy, it is often called the “mask of pregnancy.” The hormonal changes of pregnancy trigger this skin condition in many women, but it can appear in the absence of pregnancy, primarily during a woman’s reproductive years.

Melasma is a frustrating condition characterized by patchy, dark areas of increased pigmentation. These areas can be difficult to cover even with cosmetics and can cause a great deal of frustration. To make matters worse, it most commonly occurs on highly visible areas like the face that receive sun exposure.

What Causes It?
No one knows the exact cause of this common skin condition, but fluctuating hormone levels play a role, especially increases in the hormone estrogen. Sunlight is also a factor since areas that aren’t exposed to sunlight are less likely to be affected. Women that have more natural skin pigmentation are more prone to this type of irregular discoloration. Despite its link with female hormones, men can also get it, although they get it less commonly, with genetic factors playing a role in both men and women.

Genetics, hormones and sunlight exposure are most strongly linked with melasma, although nutritional deficiencies and some medications can also trigger the irregular, blotchy pigmentation. One type of medication, birth control pills, commonly bring about the symptoms. This isn’t surprising since birth control pills contain hormones.

Melasma that occurs during pregnancy may disappear on its own once hormone levels return to normal after pregnancy. Women who stop taking birth control pills usually notice an improvement too, but in some cases it can take years for the irregular pigmentation to completely go away. Most women don’t want to wait that long.

Fortunately, there are treatments that can help lighten the pigmented areas. First, it’s important to wear a sunscreen with an SPF of 30 or greater that is effective on both UVA and UVB rays since sunlight can make the problem worse. UVA rays can penetrate through glass, so put on a sunscreen daily even when you’re staying indoors.

In terms of treatments, three ingredients available without a prescription can help. Hydroquinone is a compound that blocks the synthesis of melanin, the source of the dark pigmentation. It works best when used in conjunction with glycolic acid. Glycolic acid sloughs off the outer layer of skin. This allows the hydroquinone to penetrate the skin surface so it can lighten pigmented areas.

Another ingredient called kojic acid works in a similar way to hydroquinone, by blocking the synthesis of pigment. It can also lighten pigmented areas and is best used with glycolic acid for better penetration. Glytone Fading Lotion covers all the angles. It contains hydroquinone, kojic acid and glycolic acid in a ratio that’s optimal for lightening pigmented areas. It’s also a good treatment for age spots. Use it in the morning after applying a layer of sunscreen like Avene Very High Protection Cream SPF 50. This product is hypoallergenic, non-irritating, non-comedogenic and is lightly tinted for high-powered sun protection and beautiful coverage. Reapply Glytone Fading Lotion in the evening before bedtime.

Retinoids like those found in prescription strength Retin-A can also be used to treat melasma, but retinoids can be irritating to the skin and it may take more than 6 months to see improvement. In severe cases where hydroquinone, kojic acid and glycolic acid doesn’t work, dermatologists can do a series of facial peels to lighten the pigmentation. Some doctors recommend laser treatment for severe cases, but approach this with caution. Laser treatment can worsen pigmentation in some cases.

Please note that many of the treatments mentioned contain ingredients that are not pregnancy-safe, and should only be used post-pregnancy.

The Bottom Line?
Melasma is a challenging condition to live with and treat. Fortunately, there are ingredients available that can lighten the pigmented areas over time. With a little patience, this condition that can be successfully treated.