Recently, a friend mentioned to me that her skin had suddenly developed a weird, blotchy, brownish rash when she was on vacation. “It looked like a bunch of acne scars above my lip and on my forehead,” she said. "It was like a dark shadow that wouldn't go away." But, when she finally went to the dermatologist after three weeks of my daily, annoyingly pushy reminders, she discovered that the splotches were not, in fact, scars, but melasma—a skin condition that can happen to literally anyone (cue scary music).
Just kidding; melasma is not, in fact, the kiss of death—it's just incredibly annoying to deal with. “Melasma is a complex condition that causes hyperpigmented patches on the skin,” says skin wizard, Annie Chiu, M.D., dermatologist at The Derm Institute. And the reason most derms approach melasma with a weary eye is because it really is complex, solely because it’s can be caused by a variety of factors, including “genetic tendency, increased estrogen, and skin type,” she says.
Basically, anyone with skin is at risk for developing melasma, but Dr. Chiu says you're especially susceptible if:
- You're pregnant (melasma so common in pregnant women, thanks to hormonal fluctuations, that it's earned the name "pregnancy mask")
- You have naturally darker skin (Fitzpatrick skin types IV and V are predisposed to melasma)
- You were born biologically female (again, hormones)
- You love hanging outdoors (UV rays from sun exposure stimulate skin cells to create excess pigment)
- You stare at a computer all day (the visible light from your computer, tablet, and cell phone can all trigger melasma)
See? That's pretty much the majority of the population. Which means there's also no true, one-and-done way of preventing melasma (although sun protection in the form of hats and SPF of at least 35 can help decrease, though not totally prevent, its impact on your face).
So if you do notice brown marks on your upper lip, upper cheeks, and/or on the forehead that look “patchy and widespread, rather than just a spot or two," says Chiu, then it’s likely melasma (though, of course, go to your derm for an actual diagnosis).
But before you freak out, here’s the good news: It’s treatable. The bad news? It’s kind of a pain to get rid of, solely because it requires you to be vigilant about your at-home treatments. “In office, we use peels and very specific low-level lasers to break up the pigment," says Dr. Chiu, "and we also have patients treat their melasma at home with a mix of prescription-strength hydroquinone, kojic acid, retinol, and vitamin C products, as well as be meticulous about applying UVA- and UVB-protecting sunscreen.”
So, yeah, sorry—you’re going to have to go to the derm at least once if you want your melasma treated, but after that, you can at least keep the pigmentation at bay with the best of the best spot-fading products, below. Just remember that each of them absolutely needs to be used in conjunction with daily sunscreen, or your melasma will get worse. So let's avoid that, shall we?