Very common today, melasma affects most women between 20 and 50 years. "Out of ten patients I see at the clinic, at least six treat melasma," says dermatologist Eveline Bartels of the clinic that bears her name in Belo Horizonte.
The reason for this is that although melasma is a dermatological disorder that is not associated with health problems, it directly impacts aesthetics and can greatly affect women's self-esteem. As a consequence, it can also have a major impact on the social and professional life of those suffering from the condition.
Check out a guide, made with the help of the dermatologist, to answer your questions and help to alleviate the problem.
What is melasma?
"For those who don't know, melasma are those obnoxious dark spots that show up on the face without permission and don't leave us anymore," says Eveline. These are brownish or grayish spots that appear on the skin, especially in the region of the cheekbones, forehead and fluff, due to the increased production of melanin in these areas, causing overpigmentation.
Although anyone is subject to melasma, the dermatologist points out that women should be more aware of the problem, as 90% of cases occur in women over 30 years. "It is estimated that up to 75% of pregnant women and up to 35% of women on contraceptive treatment are affected by these blemishes," he says.
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Types of Melasma
In general, melasmas look very similar, with spots of different sizes and irregular shape, with a shade that can vary from light brown to darker. But that does not mean that they are all the same. The dermatologist explains that there are three types of melasma, check out which are the following:
Epidermal Melasma
This is when melanin is deposited in the epidermis, that is, in the most superficial layer of the skin. Because of this, it is the easiest melasma to treat as it does not have to reach the deepest layers.
Dermal Melasma
As the name suggests, it is when excessive pigment deposition reaches the dermis, the innermost layer of the skin, and may be next to blood vessels, nerves, and other anatomical structures. For this reason, its treatment is more difficult.
Mixed Melasma
It occurs when the pigment deposit reaches both the dermis and the epidermis, and it is possible that one area has a higher melanin concentration than the other.
Identifying the type of melasma is essential to finding the treatment that will bring the best results. Still according to Eveline, the ideal is always to look for a dermatologist, so that, through an evaluation, it is possible to identify the type of melasma and direct to the most appropriate treatment.
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Causes Of Melasma
As Dr. Eveline Bartels explains, melasma has no definite cause and is linked to several factors, as listed below:
- Contraceptive use: Although the causes for melasma are still unclear, it is known that the hormonal factor is closely linked to the condition, with 35% of women taking the pill being affected by the problem.
- Pregnancy: As with contraceptive use, pregnancy also causes hormonal changes, such as increased estrogen and progesterone, which increase the chances of melasma appearing.
- Genetic predisposition: If other women in your family have the problem, you should be aware that you may trigger it at some point. It is also worth remembering that people with darker skin tone, such as blacks and descendants of Asians, Arabs and Hispanics, are more subject to the problem because, naturally, they already produce more melanin.
- Solar Exposure: Eveline explains that the main triggering factor is exposure to ultraviolet light and sensitive light as they stimulate both melanin production and accumulation. As evidence, melasma rarely appears in areas with little sun exposure.
The dermatologist warns that melasma can also occur in non-pregnant women who do not use birth control pills, especially if there is a genetic factor. Therefore always use sunscreen!
How to avoid melasma
Now that we have seen the main risk factors that cause melasma, it is time to know how to prevent the problem from appearing or, in many cases, getting it worse. "The heat contributes to the worsening of the spots," explains the dermatologist, "to get an idea, the steam from the hot bath, the oven, the sauna and even the closed car already make the problem worse," he says.See other tips:
- Always use sunscreen: According to Eveline, although this tip may seem like "rain in the wet", the sunscreen is one of the best friends with melasma. It should be reinforced throughout the day, if possible every three hours. "For those who wear makeup, an option to touch up the protection is a base or powder with minimum SPF 30 sunscreen," he recommends.
- Bet on the thermal water: As the expert said earlier, only heat can make melasma worse. Therefore, on very hot days, sprinkle thermal water on your face to cool off.
- Avoid facials without a dermatologist's evaluation: Laser or even waxing, as well as creams used without medical advice, can irritate the skin, increasing melanin production and aggravating the problem.
- Reuse beach hat: Although uncommon nowadays, hats are allies of those who suffer or tend to have melasma, as they generate a physical barrier to ultraviolet rays. Also, always try to stay under the umbrella.
According to the dermatologist, these are day-to-day behaviors, made with great discipline, the main tools to soften and delay the onset of melasmas.
Does Melasma have a cure? What treatments are possible?
Unfortunately, the answer to the first question is no. Melasma is a chronic condition that, even with treatment, tends to recur if care is not taken, as mentioned above. "It is very important that the bearer of these spots take care to avoid the rebound, which is the return of their sometimes worse," says Eveline.
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The good news is that nowadays there are some treatments that greatly mitigate the problem, returning the self-esteem of those who suffer from melasma. Below, Dr. Eveline Bartels lists the main ones:
Daily use creams
No, no one is talking about traditional creams found in cosmetics stores or pharmacies that, without the advice of a dermatologist, can even make the skin look worse. But Dr. explains that bleaching creams developed and indicated for her type of melasma are critical not only in bleaching but also in the maintenance phase because they inhibit melanin synthesis.
Peeling
Because they help in the process of skin renewal by removing melanin deposited on the surface layer of the skin, peelings are very welcome according to the dermatologist, but as long as they are superficial. "Deep peeling irritates the melanocytes (skin-pigmenting cell) and helps rebound the melasma," he says.
Oral Remedies
Currently, in the market, there are good antioxidant options and products that help in skin depigmentation and increased photoprotection. Remembering that they should never replace the daily sunscreen.
Micropolling + Drug Delivery
The technique, which should always be done with expert advice, is to pierce the skin with hundreds of needles to immediately apply substances that help whitening, such as vitamin C, tranexamic acid, resveratrol, among others.
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Laser
According to Eveline, this treatment option can help with both whitening and cell renewal, but care must be taken to avoid the rebound effect. Therefore, it is always best to seek medical attention. ? The most modern laser today is PicoSure, which has had excellent results in treating melasma. The combination of light and impact acts by "exploding stains", eliminating damaged tissue and stimulating the formation of new collagen fibers, as well as producing elastin, which is responsible for the skin's ability to return to its original state, "explains the dermatologist.
About home treatments, Eveline indicates investing in basic skin care habits, starting with daily use of sunscreen. And don't be discouraged! "As much as melasma is a chronic disease and has no cure, the treatment, if done correctly, is very effective and can have very satisfactory and lasting results," concludes the expert.
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