Melasma In Dark Skin Tones: What Works And What Doesn't

What is Melasma?

Melasma is a condition that causes dark splotches to appear on the face. It usually appears in women, but can also affect men and children. The spots are usually symmetrical: They occur on both sides of the face and may be found on your forehead, cheeks, chin, nose, upper lip, and neck. The spots can vary in size from small to large. The color can range from light brown to dark grayish-brown.

Determining Your Skin Type

The Fitzpatrick scale is a way of classifying skin color that goes from Type I, which is fair and very sensitive to UV rays, to Type VI, which is dark brown or black and less sensitive to UV rays. The scale was developed by Thomas Fitzpatrick, who was born in Ireland but worked as a dermatologist in Boston. He published his findings in 1975.

Skin Type	Typical Features	Tanning Ability
I	Light, pale white, freckled, light-blond or red hair, (blue eye color)	Always burns, never tans
II	White, peach, fair, (blue/green/hazel eye color)	Usually burns, tans with difficulty
III	White to light brown, olive, (dark blue/hazel/brown eye color)	Sometimes burn, tans gradually
IV	Olive, light to moderate brown (light brown eye color)	Rarely burns, tans easily
V	Brown, dark brown (dark brown eye color)	Very rarely burns, tans very easily
VI	Brown, very dark, brown to black (dark brown eye color)	Never burns, tans very easily, deeply pigmented

Types of Melasma

There are three main types of melasma: epidermal, dermal, and mixed.

Epidermal melasma is the easiest to treat. It occurs in people with darker skin tones and affects the outermost layer of skin, the epidermis.

Dermal melasma is more difficult to treat because it can affect all layers of skin, including the dermis. Dermal melasma usually occurs in people with lighter skin tones than those with epidermal melasma. People with this type of melasma may have a family history of melasma or other autoimmune diseases such as lupus or rheumatoid arthritis.

Mixed-type melasma affects both epidermal and dermal layers of skin and is most common in women over 30 years old who have had children or used birth control pills for many years. This type of melasma is often difficult to treat because it involves multiple factors contributing to its cause and effect relationship with other skin conditions such as acne and rosacea.

What Are The Symptoms of Melasma?

Melasma affects women more than men and usually occurs during pregnancy or after menopause. It can also happen after taking hormone treatments or oral contraceptives.

Symptoms of melasma include:

• Dark patches on the face that are hard to cover up with makeup
• Redness in the affected area
• Lightening of normal skin color around the affected area

You may also notice that the discoloration becomes more noticeable when exposed to sunlight or after you've been in the sun for a long time.

What Causes Melasma?

The cause of melasma is still unknown, but researchers think it may be genetic and linked to hormones. The condition develops gradually and will often disappear on its own with time.

Melasma is caused by increased levels of melanin, a natural substance that gives skin color. Melanin production increases when exposed to sunlight and other forms of ultraviolet radiation (such as from tanning beds). This causes your body to produce more melanin than usual.

Melasma can also be caused by certain medications, such as those used to treat depression or anxiety; hormone therapies like birth control pills; some acne treatments; and certain antibiotics like tetracycline and doxycycline.

What is the role of melanin in hyperpigmentation? 

Melanin is a pigment produced by melanocytes to protect the skin from ultraviolet (UV) radiation and other environmental stresses. Hyperpigmentation occurs when melanocytes produce too much pigment, which increases the number of melanin-containing cells (melanocytes).

Hyperpigmentation can occur on the skin due to many different things, including hormones, certain medications, or even genetics. Melanin may also be produced in response to inflammation or injury to the skin.

Who is at risk of developing melasma?

Anyone can get melasma, but it's more common in women than men and tends to affect people over 40 years old with darker skin tones. Pregnant women or taking birth control pills may also be at higher risk for developing this condition.

Understanding Post-inflammatory Hyperpigmentation and Melasma

Post-inflammatory hyperpigmentation is an inflammation of the skin following an injury or trauma to the skin. Melasma is a chronic condition that can occur in people with darker skin tones due to hormonal fluctuations.

Both conditions cause discoloration on the skin, but post-inflammatory hyperpigmentation appears as brown or black spots on the face, while melasma appears as dark patches on the face, particularly around the cheeks and forehead.

Post-inflammatory hyperpigmentation tends to fade after a few months without treatment since it occurs because of a healing process in your body. On the other hand, melasma is a more permanent condition that requires professional treatment for it to fade away completely.

Treatments To Avoid For Dark Skin Tones

Melasma is often treated topically with hydroquinone and tretinoin, but these options aren't ideal for everyone—especially those with darker skin tones. Hydroquinone has been shown to cause exogenous ochronosis (also known as 'black face') when applied to darker skin. It has become increasingly important for dermatologists to find alternative treatment options for melasma in dark-skinned patients.

How Do You Treat Melasma in Dark Skin Tones?

Melasma on dark skin is trickier to treat than melasma on light skin. This is because people with darker skin tones have more melanin, the pigment that gives skin its color. However, melasma can be treated by combining skin care products and prescription medications. 

Chemical Exfoliants

The treatment of melasma in dark-skinned people should involve the use of topical agents containing acids, such as:

Glycolic Acid

Glycolic acid is a chemical exfoliant that helps treat melasma by dissolving the outer layer of dead skin cells and reducing hyperpigmentation. This ingredient can be found in many products, including glycolic acid peels, at-home peels, and skincare products.

Glycolic acid works well with other ingredients such as kojic acid and arbutin because they help lighten pigmentation more quickly than glycolic acid alone.

Kojic Acid

Kojic Acid is a natural compound found in many foods, including mushrooms and berries, that has been shown to reduce the pigmentation of dark spots. Kojic acid is also known to help fade acne scars, freckles, and age spots.

Retinoids

These vitamin A derivatives work by increasing cell turnover, which helps fade melasma marks faster than other treatments. Retinoids should be used with caution on darker skin tones, however, since they can cause irritation or redness if you use too much product or too often.

Azelaic acid

This is a strong acid that helps clear up acne as well as helps relieve symptoms associated with melasma like itching or dryness by killing bacteria on your face (and preventing further breakouts!

L-ascorbic acid

This ingredient is a form of vitamin C, which has been found to reduce signs of aging and hyperpigmentation (including melasma). You'll find it in many products designed to address hyperpigmentation issues.

Arbutin

This natural skin lightener works by inhibiting melanin production in your skin. It's great for treating melasma because it prevents the buildup of excess pigment in your skin, which causes melasma to appear.

Licorice Root Extract

This extract works as an antioxidant that protects the skin from free radicals that cause signs of aging like wrinkles and dark spots on your face (such as melasma).

Resveratrol

The antioxidant properties of resveratrol help reduce inflammation and redness associated with melasma. They also help keep melanin production under control so that your skin doesn't produce too much pigment. Resveratrol is effective against melasma in lab studies and clinical trials, but it needs more research before we know how well it works for other people living with this condition. 

It's also important to avoid tanning beds or other sources of UV light when possible. This will help prevent further damage and encourage your body's natural healing process.

Lactic acid

Lactic acid is a common ingredient in exfoliating products because it's gentle enough to use on sensitive skin but powerful enough to slough away dead skin cells. Melasma is caused by uneven pigment, so exfoliating can help bring the color back into balance.

Note: It's important to know that while these treatments may reduce the appearance of melasma spots, they don't prevent them from returning if you continue exposing your skin to the sun or other triggers for melasma.

Laser Therapy

Laser therapy is a treatment for melasma in dark skin tones that works by destroying the pigment-producing cells in the skin. The laser is applied to the skin with a hand-held device that glows red and sends light waves into the top layers of your skin.

This method is effective for all types of melasma, including epidermal melasma and dermal melasma. It's also safe for all ages, as well as pregnant and breastfeeding women—though you may be more likely to experience side effects after treatment if you're pregnant or breastfeeding.

The procedure is relatively short: it only takes about an hour to complete. You'll need to wait about two weeks before resuming normal activities like heavy exercise or swimming to avoid irritation or infection at the treatment site.

Protect Your Skin from Further Damage and Overexposure To The Sun

The sun is a great source of vitamin D, but it can also cause you to develop melasma if you're not careful about how much time you spend in the sun and what kind of products you use.

• Protect your skin with a high SPF sunblock. You should also wear a hat, sunglasses, and long sleeves to block UV rays.
• Using a moisturizer that contains SPF can help keep your skin hydrated and prevent dryness, which can make melasma worse by causing inflammation in the body.
• It's important not to expose yourself to the sun too much during peak hours (10 AM - 4 PM) when UV rays are strongest. If you live in a place with little shade, try going for walks at dawn or dusk instead—this will help you get some exercise without having to worry about being exposed too much.

Is melasma permanent?

While melasma doesn't go away on its own, the good news is that it's highly treatable. Several over-the-counter products can help fade the discoloration and make you feel better about your appearance—but if those don't work for you, talk to your doctor about prescription treatments that may be right for you.

The Bottom Line

Melasma isn't harmful to your health, but it can make you feel self-conscious about your appearance if left untreated. While it's not curable, it can be managed using a topical cream to reduce the pigmentation and protect yourself from sun exposure with sunscreen.