Understanding the Causes of Melasma: A Guide to Hormones, Sun Exposure and Genetics

Melasma is a chronic acquired hypermelanosis of the skin, characterized by irregular brown patches on sun-exposed areas of the body, particularly the face. It is a common cause for visiting a dermatologist that affects mainly women and more pigmented phenotypes (Fitzpatrick skin types III-V). Because it mainly affects the face, the disease dramatically impacts a person’s quality of life.

While its pathogeny (the causes of Melasma) is not yet completely understood, there are some known Melasma triggers and many different possible treatments, including lifestyle modifications, to reduce Melasma development. In this guide, I will dive into the science behind the role of hormones, sun exposure, genetics, and various triggers contributing to Melasma and Chloasma development and how to minimize their effect on your skin and life.

Melasma vs. Chloasma: Understanding the Difference and How to Treat Them Naturally

Melanin, a natural pigment present in our bodies, is responsible for the color of skin, hair, and eyes. It’s melanin that determines our phenotypic appearance, and on a cause-effect basis, it is one of the direct causes of Melasma. It plays a vital role in absorbing UV radiation, protecting our cells from sun damage and oxidative stress. When melanin is overproduced, it can cause unwanted skin problems like hyperpigmentation, Melasma, and Chloasma.

Melasma and chloasma are often used interchangeably to describe similar skin conditions. However, there are slight differences between the two. Melasma refers to hyperpigmentation that occurs due to various factors and triggers, while Chloasma refers explicitly to the hyperpigmentation associated with hormonal changes, particularly during pregnancy. There are several Natural treatment options to deal with Melasma development, such as those analyzed in our article Top 5 Natural Remedies for Melasma and Chloasma, can be used for dealing with both Melasma and Chloasma naturally.

Melasma Triggers and Aggravating Factors

While the exact causes of Melasma are still unclear, the triggers are very well known and documented. This means that, even if you do have this condition, you can manage the development of Melasma and its effects by knowing what its triggers are.

Hormonal Factors and Melasma

Hormonal changes are one of the causes of Melasma flare ups, significantly influencing the condition’s development. It can appear during moments of volatility in hormone levels, such as those that occur during pregnancy or when taking contraceptive pills. Although the precise mechanisms by which hormones cause Melasma are not entirely known, estrogen and progesterone have shown their ability to impact the creation of melanin, the pigment that gives skin its color. Melasma can develop due to increased melanin production when these hormones are out of equilibrium.

“Pregnancy-related melasma,” known clinically as Chloasma, frequently occurs during childbearing. Melanin production is stimulated by elevated levels of estrogen and progesterone, which can cause dark patches of skin to emerge on the body.

Sun Exposure and Melasma:

Sun exposure is another crucial factor in evaluating the causes of Melasma outbreaks. An in vitro study done in 2018 concluded that Melasma could occur only on photo-exposed skin in patients subjected to high estrogen levels making it a certain culprit amongst Melasma triggers. Ultraviolet (UV) radiation stimulates melanin production, leading to a possible overproduction in susceptible individuals; exposure to the sun can exacerbate Melasma and darken existing patches. Understanding that even brief, unprotected exposure to sunlight can significantly impact your skin is essential.

Sunshine carries UV radiation that activates our melanocytes, causing them to produce melanin. Melanin absorbs UV rays and acts as a natural defense mechanism to protect the skin from damage. However, in individuals with Melasma, the increased production of melanin can lead to the formation of dark patches. To minimize the risk of Melasma, it is important to use a broad-spectrum sunscreen with a minimum SPF of 30, even on cloudy days. Wearing a wide-brimmed hat and sunglasses and seeking shade during peak sun hours are other lifestyle implementations a person with Melasma must go through.

Genetic Predisposition and Melasma

Genetics influence the risk of developing Melasma, mainly family history and genetic susceptibility. The probability of developing Melasma increases if a close relative, such as a parent or sibling, already has the disorder. A higher risk of developing Melasma may result from specific genetic variants that render the skin more sensitive to hormonal and environmental stimuli.

Researchers have identified several genetic markers that may be linked to Melasma development. However, our potential genetic predispositions cannot be changed. Knowing if we are prone to the condition is necessary so that we can take the appropriate action to lessen the impact of Melasma triggers.

Genetic predisposition is only one factor and does not guarantee the development of Melasma. Other environmental and hormonal factors also play significant roles.

Other Identified Melasma triggers

Melasma can be triggered and exacerbated by various factors. While hormonal changes and sun exposure are considered primary Melasma triggers, several other factors can worsen its symptoms. These include:

1. Heat and infrared radiation: Heat can aggravate Melasma by increasing blood flow and causing inflammation, exacerbating hyperpigmentation.
2. Skin trauma: Injuries, burns, or unsupervised skin treatments that cause inflammation or irritation can trigger Melasma or worsen existing patches.
3. Certain medications and cosmetics: Some medications, including certain antibiotics and cosmetics containing fragrances or harsh chemicals, may trigger an inflammatory response and worsen melasma in some individuals.
4. Stress and emotional factors: Chronic stress and emotional upheavals may potentially trigger or worsen Melasma symptoms in susceptible individuals.

Individuals with this condition can effectively manage their condition and prevent further aggravation by identifying and avoiding these Melasma triggers as much as possible.

Note: my experience has shown me how harsh chemicals and aggressive measures come with several disadvantages. I always suggest our clients to discuss with their dermatologist any kind of chemical treatment, as the negative sides can be larger than the benefits. At Fields of Yarrow, we prefer to steer towards 100% natural and safe solutions, that thanks to the high concentration of active agents, are more effective and satisfactory on the long run.

Treatment Approaches for Melasma

Now that you know the main causes of Melasma outbreaks, let’s talk about treatments. Several options are available, from topical creams to dermatologic procedures with synthetic and organic ingredients. The treatment choice, which an expert in the field should always prescribe, depends on the severity of the condition and individual preferences.

Some of the most commonly used treatment approaches include:

1. Topical treatments: An extensive offer of creams and other topical treatments are available. These include creams or gels containing hydroquinone (I strongly suggest to avoid it, steering towards healthier and safer natural approaches), retinoids, azelaic acid, and kojic acid. These ingredients inhibit melanin production, promote skin cell turnover, and reduce pigmentation. While they can have a natural source, due to the high cost of producing hydroquinone naturally (from bombardier beetles and some fungi), it has become an industry standard to manufacture it by combining it with other harsh chemicals that can start an inflammatory response in the body.
2. Microdermabrasion: Microdermabrasion is a gentle exfoliation procedure that can help improve melasma by removing dead skin cells and promoting cell turnover. This non-invasive procedure buffs away the top layer of skin, preventing the accumulation of extra pigment and progressively diminishing melasma spots. Microdermabrasion should be used in conjunction with other therapies and preventative measures for best results. The procedure is performed by a trained skincare professional, such as a dermatologist or an esthetician like the experts at the Fields of Yarrow studio. To directly book your skincare treatment via Whatsapp, click here.
3. Combination therapies: Some dermatologists may recommend a combination of the treatments mentioned above to manage the different symptoms of melasma and chloasma
4. Chemical peels & laser therapy: Chemical peels involve exfoliating the top layers of the skin while promoting the growth of new, healthier skin. It is relevant to note the need for an expert opinion before starting any chemical peel. Research has shown that Fitzpatrick’s skin types IV to VI are more prone to developing hyperpigmentation (PIH) after a chemical peel. Laser treatments are effective for breaking down melanin and reducing pigmentation in the skin. These treatments are typically performed in multiple sessions and require proper post-treatment care.

At Fields of Yarrow, we recommend no treatment that could harm your skin with adverse side effects. Chemical peels and laser therapy, even though useful in targeted patients, may increase inflammation worsening the signs of melasma in most people. I personally do not recommend these two treatments since the results from person to person are just too different. Contact your skin care practitioner to understand what adapts best to you.

Having many options to deal with the same problem can be overwhelming and confusing. With many products trying to target multiple or even all the symptoms, there are interactions unaccounted for that can further worsen the disease. It is essential to consult with a dermatologist or skincare professional to determine the most suitable treatment approach based on your needs, skin type, and the severity of melasma.

Prevention and Lifestyle Modifications:

Prevention is essential in the process of effectively managing melasma. Along with the appropriate treatment option, lifestyle modifications can help minimize the risk of developing another set of dark patches. Individuals can better protect their skin and maintain a more even complexion by taking proactive steps. Here are some lifestyle strategies to consider:

1. 1. Sun Protection: As I mentioned before, sun exposure is one of the primary Melasma triggers; protecting the skin from harmful ultraviolet rays is paramount in preventing melasma. UV radiation can stimulate the production of melanin and exacerbate existing pigmentation, so make protecting your skin something you do all day, every day. To safeguard it, follow these simple practices:
      • Regularly apply a broad-spectrum sunscreen with a high SPF (sun protection factor), even on cloudy days. Consider a non-comedogenic product for sensitive skin.
      • Wear protective clothing, such as wide-brimmed hats, sunglasses, and long sleeves, when exposed to the sun.
      • Seek shade during peak sun hours, typically between 10 am and 4 pm.

For more information about the natural ingredients that can help in the fight against melasma, check out the article Top 3 Ingredients to Look for in Skincare Products for Melasma and Chloasma.

1. Stress Management: Stress is believed to negatively impact the skin and contribute to melasma development in some individuals. While the exact mechanisms are not fully understood yet, incorporating stress-management techniques into your daily routine may help minimize Melasma triggers. Engage in activities promoting relaxation, such as light exercise, meditation, yoga, or deep breathing. These techniques can do more for you than reduce the impact of melasma; they can help you achieve a clearer mental state that can positively impact your mental health.
2. Dietary Considerations: Maintaining a healthy, balanced diet can benefit overall skin health. Incorporate foods rich in antioxidants, such as fruits, vegetables, and whole grains, as they may help protect the skin from free radicals and oxidative stress. Switching to the Mediterranean diet can help fight inflammation while ensuring you get all the nutrients your skin needs to glow.

Remember, melasma management requires a multifaceted approach, and results may vary for each individual, requiring patience and consistency. It is important to consult a dermatologist or skincare professional experienced in melasma for personalized guidance and treatment recommendations. By combining appropriate treatments with lifestyle modifications and preventive measures, individuals can take proactive steps toward minimizing the risk and reducing the appearance of melasma.

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