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If you've noticed dark brown or gray-brown spots on your face and neck, you could have a skin condition known as melasma. Melasma is common among people of color – primarily women between the ages of 21-40. For some, dark patches can fade on their own over time. But for people of color, melasma is typically an ongoing and long-lasting challenge.
Melasma is known by a few different names: "the mask of pregnancy" and "hormonal pigmentation" are two examples. While melasma is often triggered by pregnancy and hormonal changes, it is a chronic problem for many people of color – particularly dark-skinned African-Americans and Asians. This is most likely due to the fact that darker skin has more active melanocytes – the cells that produce color in skin – than lighter skin. Melasma typically appears on the cheeks, forehead, upper lip, nose and chin.
There are three types of melasma: epidermal, dermal and mixed. Epidermal melasma occurs at the epidermis, the outermost layer of skin cells. This type of melasma is treatable. Dermal melasma occurs in the dermis, the tissue that lies beneath the epidermis. This type of melasma doesn't respond very well to treatment. Mixed melasma is a mix of both epidermal and dermal melasma. Mixed melasma, usually improves with treatment.
The cause of melasma is not known, but what often starts it is:
Sun exposure – Ultraviolet (UV) rays stimulate melanocytes to produce pigment. This increased production continues even after sun exposure and can result in melasma.
Pregnancy – It's estimated that up to 70 percent of women develop some form of melasma during pregnancy. Dermatologists believe that the presence of estrogen and exposure to sunlight stimulate the production of melanin, which, in turn, cause dark spots and dark patches.
Oral contraceptives – Like pregnancy, oral contraceptives increase the levels of estrogen, which triggers the production of melanin. Certain oral contraceptives, like Depo Provera, may be more likely to cause dark spots – especially among women of color.
Hormone Replacement Therapy – Women of color who take hormone replacement therapy after menopause may be susceptible to developing melasma dark spots. Again, changes in hormones, combined with exposure to sun, can act as triggers.
Pregnancy and birth control induced melasma often fades on its own. But people of color must be diligent about applying melasma treatments year-round to prevent and minimize the appearance of dark spots.
Avoid sun exposure. This may seem impossible, but there are simple changes you can make to avoid sun exposure: walking in the shade, minimizing visits to the beach and wearing visors or hats on a daily basis.
Use sunscreen. Women of color should wear a broad-spectrum sunscreen to block out UVA and UVA rays and minimize the appearance of dark spots.
Switch birth control. See your doctor to discuss the possibility of switching to a nonhormonal birth control.
Use a gentle skin system. Rx for Brown Skin's Dark Spots and Tone Correcting System helps reduce the visible melasma dark spots, minus the harsh, harmful ingredients that can dry and irritate the skin.
See a dermatologist. There are a variety of melasma treatment options available by a prescription from a dermatologist. These typically include topical medications that contain the skin-bleaching ingredient hydroquinone, along with steroids and retinoids.
For people of color, it's important to understand that there is no single melasma treatment that will minimize or prevent dark spots for forever. The most effective melasma treatment for people of color is a combination of practices and solutions that must be incorporated into your daily skincare routine indefinitely.