Nurx offers prescription hydroquinone to treat melasma for $30 per month.
Chloasma is a mouthful, so if you’ve recently been diagnosed with this skin condition, you might be a bit worried. First of all — it’s not as serious as it might sound and is actually a fairly common condition. Learn more about chloasma and how you can get treatment for it below.
What Is Chloasma?
Chloasma — better known as melasma — is a skin condition where you get patches of hyperpigmentation across your face. These darker areas are usually symmetrical, meaning they appear on both sides of your face in roughly the same pattern. While anyone can get melasma, it’s definitely more common in women — specifically pregnant women. In fact, you might also hear chloasma called the “mask of pregnancy.”
Melasma happens because melanocytes, the cells in your skin that produce the pigment, are hyperactive. This extra pigment, called melanin, has nowhere to go, so it collects in patches on your skin, leading to the tell-tale splotches of melasma.
The main symptom of melasma is having a patch of skin that looks darker than surrounding skin. For many people, the splotches are dark or light brown, though you might also notice a grayish-blue hue. They may also have a net-like or freckle-like appearance, though they won’t have a raised texture. Generally, these patches can be anywhere from a third of an inch to about 4 inches in size — meaning they can cover quite a bit of your skin.
While melasma can occur on any part of the body that’s frequently exposed to the sun, it’s most common on the face. In particular, you’re likely to see it across your cheeks, chin, nose, forehead, or upper lip.
Causes of Chloasma (Melasma)
There are a few different causes of melasma. Though hormonal changes are the most common, studies have also linked melasma to sun exposure and genetics.
When a person is pregnant, they undergo numerous hormonal changes to help their baby grow. Unfortunately, some of these changes might also be the cause of melasma, though scientists aren’t exactly sure how. During pregnancy, estrogen, progesterone, and melanocyte-stimulating hormone levels spike, especially during the third trimester. This cocktail of hormones could be what sends melanocytes into overdrive.
It’s not just pregnant people who are affected by melasma, though. Those who take estrogen- or progesterone-based birth control also have a higher risk of developing melasma. These birth control methods deliver a heightened dose of hormones to stop your body from ovulating each month, but they could have the unintended side effect of causing melasma.
Finally, postmenopausal women who take progesterone to alleviate their symptoms also have a higher chance of developing melasma.
Next to hormones, sun exposure is the most prevalent cause of chloasma. As mentioned earlier, melasma typically occurs on sun-exposed parts of the body. Scientists believe this is because harmful UV rays can cause changes to the skin.
The more UV radiation you expose your skin to, the more free radicals are released. Free radicals are small, unstable particles that can cause damage to cells if left unchecked. Scientists believe that they are responsible for overstimulating melanocytes to produce extra melanin.
Having a genetic predisposition to melasma could give you a greater chance of developing the condition. For example, if your mom or grandma had it, you’re more likely to develop it as well. Research reports 33% to 50% of chloasma patients have a family history of the condition.
People of certain ethnicities are also more likely to develop melasma. It’s more common in people with light-brown skin types that come from areas with a higher rate of sun exposure. For example, people with Native American, Black, Asian, or Latin heritage are more at risk.
How to Minimize Chloasma (Melasma)
Unfortunately, there is no guaranteed and universal cure for melasma, and once you’ve experienced the chronic condition, you’ll always have a tendency to develop spots. But the good news — it’s not permanent. Some women experience fewer dark patches after they give birth or stop taking their birth control. Many women find their melasma disappears with proper treatment. And preventative care can also help to minimize its appearance.
The first and easiest step is to minimize your sun exposure. As we noted above, the sun can be a trigger for melasma, so try to stay indoors during the sunniest parts of the day. You don’t have to completely abstain, however. If you do go out into the sun, make sure to use a strong SPF of 30 or higher and wear a hat and sunglasses to shield your face. Also, try to stick to the shade if you can.
Other than limiting sun exposure, treatment for melasma involves slowing down your melanocytes so they stop producing so much melanin. By doing this, you can hopefully even out your skin tone.
Most dermatologists will recommend starting with a hydroquinone cream. Hydroquinone should only be applied to your hyperpigmented patches. It works by inhibiting an enzyme melanocytes need to produce melanin, which should eventually reduce pigment levels.
Your doctor may also combine hydroquinone with tretinoin. Tretinoin is a powerful retinoid that increases skin cell turnover — meaning it can help you shed pigmented skin cells faster, so they can be replaced with new, non-pigmented cells. As a bonus, it’s also a powerful anti-aging cream.
Azelaic acid is another option that dermatologists often use to treat melasma, and it can be used long term. It has antimicrobial and anti-inflammatory properties, and it increases cell turnover. It’s often used for brightening dark spots, evening skin tone, and reducing hyperpigmentation. It comes in a variety of strengths, so if you have sensitive skin or are currently pregnant, you can start with a gentler formula and gradually work up to stronger products.
There are a few other over the counter options that your dermatologist might recommend, especially if you have skin that’s on the sensitive side. Vitamin C and kojic acid, for example, are also able to even skin tone. They might be alternatives for you if you’re having a bad reaction to hydroquinone, tretinoin, or azelaic acid.
If these medications are ineffective, the next step is to try an oral medication called tranexamic acid or to pursue medical procedures, such as a chemical peel, laser treatment, or microneedling. However, these procedures are somewhat more invasive and can have negative side effects, including worsened melasma. That’s why most doctors will only recommend these as a last resort for patients who have exhausted other options without satisfactory results.
Get Melasma Treatment Without Leaving the Couch
There’s no reason to let melasma get you down. If you’re unhappy with the patches of hyperpigmentation that have cropped up on your face, visiting a dermatologist can help you start on the path to a more even skin tone.
With Nurx’s telehealth services, you don’t even have to leave the house! You can start by filling out a skin questionnaire that is reviewed by a licensed medical provider. They’ll take a look at your symptoms and prescribe a medication regimen specifically for your needs. Best of all — your new medication will be shipped to you! Learn more about our melasma treatment today.