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Is Melasma Normal?

It’s not uncommon to have freckles or other small areas of discoloration on your skin. But when these patches of hyperpigmentation spread across your entire face, they could be a condition called melasma.

First things first — melasma isn’t harmful. It’s not a sign of skin cancer or another disease that can hurt you. But the telltale discoloration can definitely do a number on your self-esteem. While the condition is common, especially for pregnant women, it isn’t what society deems as “normal.” 

Learn more about exactly what melasma is — including who’s most likely to get it — so you can take steps to clear up your skin.

Get Melasma Treatment At Home

Nurx offers prescription hydroquinone to treat melasma for $30 per month.

What Is Melasma?

Melasma is a type of skin disorder where you develop dark brown, light brown, or grayish-blue patches on your skin. Usually, these show up on your face, particularly on your cheeks, chin, forehead or above the upper lip. These aren’t raised or inflamed patches — rather, they’ll look more like freckled spots.

There are three main kinds of melasma, each with slightly different presenting features. Epidermal melasma is when your spots have a dark brown color with a well-defined border. It primarily affects the different layers of the epidermis, which is the top layer of skin. If you have this type of melasma, you might also have enlarged melanocytes. These are cells that form melanin, the pigment that gives your skin color.

Dermal melasma involves spots that are light brown or bluish. They might also have a blurry border. The reason these spots appear murkier is that they’re in the dermis — the deeper layer of skin underneath the epidermis. This makes them harder to treat.

Finally, mixed melasma is a combination of these two types of melasma. You could have both blue and brown patches if both the epidermis and dermis are affected.

Melasma by the Numbers

Over 5 million people suffer from melasma in the United States. The majority of these sufferers are women. In fact, research shows that the female-to-male ratio of melasma is 9:1. But there is good news. Both men and women can take advantage of melasma treatment to clear up their symptoms.

Even among women, certain groups are more likely to develop melasma. Pregnant women are particularly susceptible to developing melasma. You might even hear it called the “mask of pregnancy” because of how often it affects pregnant women.

We’ll go into this more later, but this generally happens because of an influx of hormones. That’s also why melasma is extremely rare before puberty — there are just not enough hormonal interactions going on to cause the condition.

Melasma is more common in certain ethnicities. In particular, Southeast Asian women appear to have the greatest risk, with up to 40% of certain populations developing the condition. Another study that followed a group of female Arab Americans living in Michigan noted a diagnosis rate of 13.4% to 15.5%. Latino women living in the southern United States also had an 8.8% rate of developing melasma. Melasma is statistically more common for people who have darker skin tones. Some researchers suspect this is because they historically come from areas of the world with a lot of sun exposure.

Age also plays a role in who develops melasma. Because melasma is triggered by hormonal interactions, it’s most common in reproductive-age women. One study that took a look at 312 melasma cases found that the average age of onset was around 30 years old. However, it’s interesting to note that the average age of melasma patients was closer to 33 years old — meaning many patients waited three years before seeking treatment.

What Causes Melasma?

Scientists have narrowed down the root cause of melasma to two main catalysts: hormones and sun exposure. However, genetics are also worth noting because your family history can affect how your body reacts to these factors. In addition to the ethnicity-related statistics above, several studies have found patients with melasma often have at least one relative with the condition. In one international study with 300 melasma patients, 48% reported that they have a family member with melasma.

When it comes to hormonal causes, the female sex hormones eestrogen and progesterone can induce melanocytes to make more melanin (or induce melanogenesis), particularly when combined with UV light.  There are a few ways hormones can fluctuate and contribute to melasma. The first is being pregnant. During pregnancy, the levels of estrogen and progesterone rise dramatically. 

Hormones can also fluctuate as a side effect of taking hormonal birth control pills. These pills work to prevent ovulation by delivering doses of estrogen and progestin. The hearty amount of estrogen can have the unintended side effect of stimulating melanin production.

Sun exposure is another main cause of melasma. When your skin is exposed to UV light, it reacts by producing more melanin to block out these harmful rays. For most people, the skin knows when to stop. But for people with melasma, their skin might keep producing melanin in excess.

Don’t Let Melasma Get You Down

While melasma is a common condition, you don’t have to suffer with it! There are things you can do to reduce your hyperpigmentation and improve your complexion. 

Melasma treatment from Nurx is customized for your specific skin type and prescribed by a licensed medical provider. With a mix of hydroquinone, azelaic acid, and tretinoin cream, you can use science to fight back against your skincare woes. 

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