Melasma is one of the most frustrating and common hyperpigmentation disorders. It is almost always seen on the face—especially the upper lip, cheeks and forehead. Melasma is most common in women, but is also seen in men.
The Role of Hormones
Melasma is known to be associated with both the naturally occurring hormones in our bodies and with exogenous hormones like hormone replacement, birth control pills, hormone-containing IUDs (I see melasma that gets worse in patients who have this type of IUD very often in my office) and other sources of “natural” estrogen and progesterone hormone supplements.
The Role of Sun & Heat Exposure
Ultraviolet light (sun exposure) and heat are both well-known contributing causes of melasma. The less-understood role of heat cannot be understated as melasma is definitely more common in those who work over hot stoves, fires or ovens. Heat and sun likely contribute by contributing oxidative energy to the pigment production pathways in the skin. This highlights the reasoning for the use of anti-oxidants and free-radical scavengers like gluconolactone IN ADDITION to skin brighteners and tyrosinase inhibitors like 18-B glycyrrehtinic acid, and niacinamide (a melanosome transport inhibitor) in the treatment/prevention of melasma. Of note, 18-B Glycyrrhetinic acid was recently sited to be the most effective plant-based skin brightener in the world.
Post-Inflammatory Hyperpigmentation & Hyperpigmentation
In light and darkly-pigmented skin types, any sort of cut, scrape, burn, wound or even a mild scratch can result in an unsightly hyperpigmented dark spot on the skin.
Prevent Inflammation & Scabs
To prevent hyperpigmentation from forming, it may be necessary to prevent inflammation from happening in wounds in the first place. It is also very important to prevent the skin from forming a scab. Scabs generally take longer to heal, are more likely to get infected (and then inflamed and pigmented) and are pretty much guaranteed to scar more than a wound that is never allowed to form a scab.
How can I prevent a scab and pigment-causing inflammation from forming?
TrueLipids® Boo-Boo & Bum Balm is an extremely effective solution in preventing a scab from forming on a minor cut, scrape, burn or wound. It may also be very beneficial in preventing inflammation with the natural, anti-inflammatory from licorice root: 18-B glycyrrhetinic acid. 18-B glycyrrhetinic acid was recently found to be the most effective skin-brightening and lightening plant-based molecules in the world. This is probably due in part to its anti-inflammatory properties I recommend using a skin protectant with an anti-inflammatory natural 18-B glycyrrhetinic acid like that found in TrueLipids Boo-Boo & Bum Balm.
Treatments
I like to grade the treatment of melasma according to two things:
1. Least invasive/fewest side effects, and 2. Effectiveness. Based on this algorithm, I recommend following the treatment plane below starting with skin brightening products that include pharmaceuticals like hydroquinone, retinoids (tretinoin and tazarotene)
Hydroquinone (an oxidant and possible carcinogen that is also often contaminated with mercury (causes leukemia and other cancers). Because of this controversy, the use of hydroquinone has fallen out of favor with many people and the effort to find other, safer alternatives has begun. Luckily, there are good, safe alternatives.