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Treating Melasma “THE MASKED BANDIT”

By Bernard I Raskin, M.D.

Melasma shows up as brown spots or splotches on the forehead, cheeks, jaw line or upper lip that is triggered by hormones and light. Hormones stimulate the growth of cells that make brown pigment (melanocytes). And light stimulates the production of even more brown pigment (melanin). Melasma can appear when a woman’s hormones change, whether through pregnancy, oral contraceptives, or hormone replacement therapy after menopause. So you have two problems: too many cells making brown pigment and light constantly stimulating them.

If you get melasma from postmenopausal hormone replacement and can’t stop the HRT for health reasons, then use sunscreen, stay out of the midday sun, and keep your hat on. If you have melasma from hormones or prior pregnancies, see your dermatologist first. Women of color are prone to melasma, and it is a significant problem for many. But people of any skin type can get melasma. Melasma can be difficult to treat. Talk to your dermatologist about prescription “bleaching” creams and other treatments such as Peels and Microdermabrasions. All these simple measures will help to limit the blotchiness of melasma.

Be sure to apply a sunscreen with a SPF fifteen or greater with zinc, every single morning and reapply it frequently. Try using ColoreScience Sunforgetable mineral powder SPF 30 OR 50 for convenient reapplication throughout the day and for use over makeup. You should also wear a hat. You will not have success treating melasma if you don’t block light. Every time ultraviolet light hits these brown spots it makes them worse. Your sunscreen must block UVA as well as UVB rays.

Prescription “bleaching” creams-These creams don’t really “bleach” anything. Instead, they block the production of excess pigment (melanin) in the skin. The pigment-making cells are like little factories that churn out microscopic, brown granules. The bleaching creams partly shut down the factory so less brown pigment granules are made.

Peels and microdermabrasion – Both peels, and microdermabrasion are done in a series, they work by increasing cell turnover. This speeds the transit of that unwanted pigment out of your skin. These treatments are helpful for all types of pigment issues regardless of their origin.
For more please contact Advanced Dermatology & Cosmetic Care at 661.254.3686 or visit