Melasma - Causes

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At what stage in your life did melasma occur, and what was the cause (if known)?

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What causes melasma?

The exact cause of melasma remains unknown. Experts believe that the dark patches in melasma could be triggered by several factors, including pregnancy, birth control pills, hormone replacement therapy (HRT and progesterone), family history of melasma, race, antiseizure medications, and other medications that make the skin more prone to pigmentation after exposure to ultraviolet (UV) light. Uncontrolled sunlight exposure is considered the leading cause of melasma, especially in individuals with a genetic predisposition to this condition. Clinical studies have shown that individuals typically develop melasma in the summer months, when the sun is most intense. In the winter, the hyperpigmentation in melasma tends to be less visible or lighter. Heat, such as that experienced in a bakery or factory, is also thought to be a cause.

When melasma occurs during pregnancy, it is also called chloasma, or "the mask of pregnancy." Pregnant women experience increased estrogen, progesterone, and melanocyte-stimulating hormone (MSH) levels during the second and third trimesters of pregnancy. Melanocytes are the cells in the skin that deposit pigment. However, it is thought that pregnancy-related melasma is caused by the presence of increased levels of progesterone and not due to estrogen and MSH. Studies have shown that postmenopausal women who receive progesterone hormone replacement therapy are more likely to develop melasma. Postmenopausal women receiving estrogen alone seem less likely to develop melasma.

In addition, products or treatments that irritate the skin may cause an increase in melanin production and accelerate melasma symptoms.

People with a genetic predisposition or known family history of melasma are at an increased risk of developing melasma. Important prevention methods for these individuals include sun avoidance and application of extra sunblock to avoid stimulating pigment production. These individuals may also consider discussing their concerns with their doctor and avoiding birth control pills and hormone replacement therapy (HRT) if possible.

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See what others are saying

Comment from: Lady Mai, 35-44 Female (Patient) Published: January 31

I'm 35 years old. I did not have melasma during pregnancy but I started developing it afterwards when I went off my Synthroid for my hypothyroidism. It's bad now. I tried Obagi but it didn't make a difference plus I hate the smell of hydroquinone. I started using Lumnaskin for about 4 weeks now. My skin is lighter and firmer and melasma is lighter. My dermatologist asked what I did. I think maybe the Synthroid might have something to do with it.

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Comment from: Lisa Torres, 45-54 Female (Patient) Published: May 21

I have melasma. Mine started when I started peri-menopause. So mine is due to hormonal changes. My dermatologist prescribed a cream for me called Tri-Luma. About 5 days later, there was a noticeable difference and the brown spots looked so much lighter. Of course I use a really good sunscreen called La Roche-Posay. Most insurances don"t cover the cost of the Tri-Luma because it is for cosmetic purposes. The cost with tax is around $120.00 but well worth it. You only use very little.

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