If you’re reading this post, then I’m guessing you have melasma or are at least wondering what it is. If you have it, you’re likely looking for answers on how to get rid of it. I am too! In this post, I’ll cover the basics of melasma and my experience at the start of it including what I’ve tried, what has worked or not worked for me, and my thoughts on all of it.
I decided to write about this topic partly as an outlet for my thoughts on what I’ve been experiencing and to share my journey with others who are going through the same.
While I don’t have all (or many) answers regarding melasma, I hope that if you have this condition, you can read this and take comfort knowing that others like me recognize the challenge you’re going through.
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What is melasma?
According to the Cleveland Clinic, melasma is a skin disorder characterized by brown and blue-gray patches or spots on the skin. This is caused by overproductive melanocytes, the cells that produce melanin.
Excess melanin leads to darkening of the skin, often on the face, although it can happen on any part of the body.
Melasma is commonly found on the face on the forehead, cheeks, nose, chin, and upper lip.
Common risk factors from Medical News Today:
- Sun exposure – UV rays can cause melasma
- Pregnancy – this is sometimes called “the mask of pregnancy” because the hormones during pregnancy can cause it
- Being female – Women are affected 9x more than men (90% women, 10% men)
Common causes of melasma:
- Increased sun exposure – spending a lot of time in the sun results in sun damage to the skin
- Hormone changes such as from pregnancy, birth control, and menopause
- Hormonal imbalances from health conditions
- Use of skin care products and treatment such as some laser treatments and facial peels
- Medications – some medications make the skin more sensitive to the sun
I’ve been learning about melasma for the past half a year or so as I’ve been experiencing it (sometimes also called hyperpigmentation). I have had a small dark spot on the side of my face by my temple for many years.
I didn’t think much about it as it stayed small, was out of sight unless I turned my head in the mirror, and could be covered with makeup.
On a visit to the dermatologist seven months ago, I asked about what seemed like some small brown spots like raised freckles on my face. I couldn’t recall when they appeared.
They just seemed to be there one day when I noticed them. I learned that those were due to sun exposure. They were easily lasered off, but the other dark spots would be tougher to treat.
I still have dark spots on the side of my face by my temple and another on my left upper cheek by the eye I think due to it being my driving side.
I have light changes in color elsewhere that I think is not really noticeable with makeup on or anything people would find out of the ordinary. But I noticed them and feel they are getting worse.
What I’ve tried so far
I’ve tried two in-clinic procedures. I’m unsure of their specific names.
One was labeled on the receipt as electrodessication, which is a procedure in which a thin electrode delivers an electric current to remove things such as cherry angiomas and skin tags.
The procedure only took a few minutes. It felt like small pricks, nothing too painful. This removed the small raised freckles I had but did nothing lasting for the darker spots in the skin.
On another visit, I had another treatment which I think was cryotherapy. I recall being sprayed in a few spots with what was probably liquid nitrogen.
The patches of skin that were sprayed then froze. The idea is that the cells would die and new cells that don’t overproduce melanin would take their place.
Both of these treatments had only temporary effects. I placed ointment and adhesive bandages over them for a few days until they healed. Within days of healing, they returned to the way they looked before treatment.
I want to say that the cost for these two treatments was about $450-500 total.
2. Hydroquinone 4%
After the procedures did not work, my dermatologist recommended topical treatments starting with hydroquinone at 4% strength.
Hydroquinone is considered the gold standard for melasma treatment. It’s is only available at 4% by prescription in the US.
You can get in lower percentages without a prescription. I used this for probably about two months with no improvement to my melasma.
The next thing my dermatologist recommended was Tri-luma, which is a cream containing fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05%.
Please read up on Tri-Luma if you’re interested or intended to use it.
For some women, Tri-Luma or specifically hydroquinone is the only thing that fades their melasma. It also has the potential for serious side effects and negative results, which is why you have to be careful using it.
I’ve read of some women who saw initial improvement have their melasma come back meaning temporary results.
Some women had their melasma come back darker. Others had their skin turn blue-gray. Others had light spots around the dark spots, which became permanent.
I applied Tri-Luma once a day at night to the dark spots on my face. I did that for 3 weeks and then took a 4th week off. I did this for two months without seeing much effect. I intended to try it for one more month (3 months total) but gave up on it.
My melasma spots would change by the day and still do, not because of Tri-Luma. That’s just how they are.
The first night I tried Tri-Luma, I woke up the next morning with lighter skin around the dark spots like a ring around them.
The medication said to apply it to cover a half inch or so outside of the area you’re targeting. That’s when I realized this can have some serious unintended effects. The lighter skin normalized within a day though.
The best I got was maybe a week of mild lightening where it would be only somewhat noticeable under concealer. My skin is stubborn and I didn’t want to push using Tri-Luma.
I always had a reddish area when using it due to the irritation, and I was afraid of some of the negative effects I described above. I felt ready to move on to something else.
4. Vitamin C
About 4 months into this journey (3 months ago), I read about someone who had success using vitamin C combined with something else to treat her melasma. Her melasma appeared due to excessive sun exposure, which is likely the same as mine.
I ordered this Korean vitamin C serum online and began using it 1-2 times a day. Some people experience skin irritation or dryness when they start using it. I didn’t experience any issues probably because I mixed the 1-2 drops in with my moisturizer when I used it.
The vitamin C made my face seem brighter and smoother. I was actually very happy with that aspect of it, but it didn’t do anything for my melasma.
What I’m doing now
I’ve stepped up my efforts to protect myself from the sun over the past 4 months.
My melasma is slowly getting worse and I’m not 100% sure of all the triggers, so I’m doing everything I can right now to try to learn and manage it.
- Eucerin Anti-Pigment regimen
I recently learned about Eucerin’s Anti-Pigment line of products on a Facebook group page for melasma. After reviewed Eucerin’s page about the products and reading some of the studies testing the products, I decided to give it a try.
The products are hard to locate in the US. I ordered them online from Caretobeauty. Compared to prescription medications like Tri-Luma, Eucerin’s products are very reasonably priced.
I have the spot corrector, dual serum, day cream, and night cream. I use these in some combination applying 3-4 times per day as part of my morning and evening skincare routines.
One study said that people who did 4 applications a day saw greater improvement than those that did 2 applications a day. They say not to do more than 4 applications a day.
I think that’s because that’s the limit of what’s been studied. I’m not sure if there would be any negative side effects from doing more. Nonetheless, I’ve stuck to the company’s recommendation.
I’ve been using Eucerin products for a total of 4 weeks now. I started out at 1x/day and worked up to 4x/day, not because I was concerned about side effects. It was only because I didn’t have all the products when I started.
I think I see some fading of one small spot, but it could be my imagination. I need to give it more time.
I’ll eventually update this post or write a new post about how Eucerin turned out for me.
You can be affected by direct sunlight, indirect sunlight from UV rays reflecting off of things even when you’re indoors, and blue light coming off of electronic screens.
UV rays go through windows and can even go through clouds and fog on overcast days.
I’ve started applying sunscreen every 2 hours. It’s easy to do on the weekends because I have unstructured time. It’s not as easy to remember or find the time to reapply sunscreen when I’m at work. I try do it when I can.
I’m experimenting with lotion, stick, and powder sunscreens. As part of my morning routine I apply a chemical sunscreen and then a mineral sunscreen a short while later after it dries.
Sunscreens I’ve tried or am trying:
- Bondi Sands SPF 30 sunscreen lotion
- Bare Republic SPF 30 clearscreen sunscreen lotion
- Banana Boat Kids SPF 50 mineral sunscreen lotion
- Hello Bello SPF 30 sunstick
- Elta MD UV Clear Broad Spectrum SPF 46
- Colorescience Sunforgettable® Total Protection™ Brush-On Shield SPF 50
- AHC Natural Perfection Double Shield sunstick 22g SPF50+ PA++++
I prefer to use SPF 50 or higher, but I found or already had some that were SPF 30. I don’t think it’s an issue because I layer on sunscreens.
For now, I’m really liking AHC and Colorescience for my face and Bondi Sands for my neck, hands, and feet.
I would use all of them again except for the Banana Boat Kids one because it contains only 4.5% titanium dioxide and 6.5% zinc oxide (11% total) while many other brands have one active ingredient or combinations totalling 21% or 22%.
I can’t say for certain how well each works because I’m not out in the sun seeing if I burn or not to test them. I consider the active ingredients, how they feel when on, if they leave a white cast, the SPF and PA rating, and the cost.
I plan to try other sunscreens when I’m done with these and stick to the ones I like. I’ll post an update about sunscreens as well.
3. Wearing a hat & mask
I’ve never been a fan of wearing hats. They’ve always been too small for my head, leaving me with discomfort and even headaches. I would sometimes wear an adjustable visor and sunglasses when I walked the dog, but they don’t cover much of my face.
I decided I had to get serious about wearing a hat so I bought this adjustable floppy straw hat and a portable roll-up hat that I can take with me everywhere.
I’ve also been wearing sun protective masks. My favorite one for fit is one I purchased online directly from China, but the black dye would come off on my face when I wore sunscreen or sweat.
I like these Coolibar masks. They’re lightweight, comfortable, and washable.
I just wish they fit a little better to cover more of the temple and just below the eyes. It may be that they’re a little big because they’re considered men’s masks although anyone can wear them.
4. Taking Heliocare pills
Heliocare pills are a skin care dietary supplement that contain polypodium leucotomos extract (PLE) meant to protect skin from the effects of free radicals. The pills are supposed to be used in conjunction with and not as a replacement for sunscreen.
While I have no way to test if the pills work or not, this review reports on a study where women with melasma showed improvement after taking polypodium leucotomos extract twice daily for two weeks versus those in a placebo group.
I also read of minimal to no side effects for people who take this supplement.
After reading that study and reviews on the product, I decided to order these Heliocare pills online and started taking them this month. The instructions say to take 1 pill a day.
- Miscellaneous things
There are other small things I’ve been doing as well:
- Walking the dog early in the morning or later at night when the sun is low in the sky. This protects me from heat and unnecessary UV exposure. My husband already walks the dog more than I do but has been taking on some of my walks so that I can avoid the sun.
- Running the AC in the car. Normally I keep the AC on low and for short amounts of time even when I get into a hot car. Now I run it higher and keep it on longer to keep myself cool.
- Taking cooler showers. Some of my melasma spots show up or turn red when showering, which makes me think that heat is a trigger for me. Taking cooler showers has helped reduce some of that redness.
I’m looking forward to the end of summer when the days get shorter and the weather gets cooler. Some women say their melasma fades during the winter months when they have less sun and heat exposure.
I plan to stick with the Eucerin regime for at least 3 months. I may try it longer for up to 6 months depending on if I see any improvement from it.
I’d like it if this works and this can be my go-to indefinitely.
- The cost is reasonable for the products.
- No negative side effects or not serious ones that I know of.
- I want to stay off of hydroquinone and avoid lasers and chemical peels. Hydroquinone is generally recommended to be used in cycles because it can thin the skin and other side effects.
Why not Musely (just yet)?
Musely is a popular product for melasma in the US. Many women have found it helpful for fading and then maintaining their melasma. The company provides several items for melasma. One of them is for hydroquinone at 12%.
I want to stay off hydroquinone if I can, but I will move on to Musely if Eucerin doesn’t work for me.
I also didn’t want to start Musely in the summer. Hydroquinone can make you more susceptible to the sun, and many people have a hard time staying out of the sun in the summer. I’ve read many women recommend starting it in the fall or winter.
I’ve read about people trying many things to get rid of their melasma. I haven’t researched or tried all of these, but if my plan above doesn’t work, then I may move on to them.
Please consult your doctor or dermatologist before trying any of these because some of them can have negative side effects.
The cause of melasma is different for each person, so there is no one common solution for everyone. If you have it, you need to figure out the root cause of yours to figure out the best treatment plan for you.
Nonetheless, these are some I would consider trying in my case:
- Additional laser treatment
- Chemical peels
- Kojic acid
- Glycolic acid
- Tranexamic acid
I’ll wrap up this post with some information and thoughts about my experience.
- I might be obsessed
All together everything that I’m doing might sound obsessive. My husband and a friend of mine think it is.
I think it’s normal to research and do whatever you can once you’re diagnosed with something that affects your life.
I actually don’t mind the measures I’m taking all that much. I don’t spend a lot of leisure time outdoors in the sun.
Wearing sunscreen, sunglasses, a hat, and a mask are things I should be doing for sun protection whether I have melasma or not.
What bothers me most is the dark spots on my face. What I’m doing now seems minor compared to the risk that my melasma will grow out of control.
2. Melasma is a chronic condition
Some women experience melasma only once for a short time. They may only have it during pregnancy and then it fades. Or they respond well to early treatment.
For most women, melasma is a chronic condition. The dark spots may fade with time and treatment, but it’s an ongoing battle requiring diligence and prayer to keep them from coming back.
I know that I’m going to have to deal with this for the rest of my life. I have to try to avoid the sun, put on sunscreen several times a day, and wear sun protective gear.
It can be overwhelming to think about long-term lifestyle changes necessary to manage melasma.
3. Find support if you need it
While melasma is a benign cosmetic condition, it can affect self-esteem and overall quality of life. It’s not unheard of for women with this condition to have depression or at least be depressed about it.
I’ve found Facebook groups for melasma to be supportive and educational. It’s where I encountered people who have melasma like me. It’s where I learned about different treatments such as the Eucerin Anti-Pigment line.
Check out a group or two if you’re looking for support or to learn more about what’s worked for others.
That’s a wrap on this first stage of my melasma journey. Wish me luck as I move forward with treatment. I wish the same for you too.