Splotched! Understanding and Managing Melasma

Melasma often develops between the ages of 20 and 30 and can persist for years. This common skin condition is characterized by symmetrical patches of darkened skin, caused by an overproduction of melanin. While it most often appears on the face, it can also affect the chest, upper arms, and back.

Though melasma is a chronic condition, it can be effectively managed with the right knowledge, consistent care and a thoughtful skincare routine.

What Triggers Melasma? Melasma is the result of overstimulated melanocytes—the pigment-producing cells in the skin and eyes. When triggered, these cells produce excess melanin, leading to the formation of dark patches. Understanding the most common triggers is key to managing this complex condition.

Sun Exposure: Sun exposure is the leading trigger for melasma. Even minimal UV exposure can stimulate melanocyte activity, so daily protection is essential. Use a broad-spectrum sunscreen with SPF 30 or higher, ideally with physical blockers like zinc oxide or titanium dioxide. Unlike chemical sunscreens, which absorb UV and convert it to heat (a potential aggravator of melasma), physical sunscreens reflect UV rays and are gentler on sensitive, pigment-prone skin.

Hormones: Hormonal fluctuations are one of the most common drivers of melasma. Changes related to birth control, pregnancy (often referred to as “the mask of pregnancy”) or perimenopause can all stimulate excess melanin production.

Genetics: Genetics can play a significant role in melasma. According to the American Academy of Dermatology, nearly half of those with melasma have a family history of the condition. While we can't change our genetic blueprint, understanding predispositions empowers us to take proactive, preventative steps tailored to their skin’s needs.

Medications: Certain medications are known to trigger melasma or make the skin more sensitive to sunlight. These include hormonal treatments such as birth control pills and hormone replacement therapy, as well as drugs like phenytoin.

Inflammation: Chronic internal inflammation is a lesser-known but powerful trigger for melasma. When the body is inflamed, it can stimulate melanocytes and increase melanin production. So support skin health from within through an anti-inflammatory lifestyle—nourishing, whole-food-based meals, regular physical activity and stress-reducing practices. These habits not only calm systemic inflammation but also enhance the skin’s overall resilience and clarity.

Heated Environments: Excessive heat—whether from the environment or physical activity—can worsen melasma. Activities like hot yoga, sauna sessions, grilling, or working in high-temperature professions may activate pigment cells. If you are prone to melasma be mindful of prolonged heat exposure and take steps to cool the skin when possible.

HEV Light (Blue Light): High Energy Visible (HEV) light—commonly emitted by phones, tablets and computer screens—can have surprising effects on the skin. Unlike UV rays, HEV light penetrates deeply and may contribute to:

• Collagen breakdown, accelerating signs of aging

• Melanin production, potentially worsening hyperpigmentation like melasma

• Sleep disruption, which impacts overall skin regeneration and hormonal balance

Stress: Even subtle, everyday stress can impact the skin—triggering inflammation, disrupting hormone balance and exacerbating melasma. Often, the most damaging stressors are the ones we overlook. Hidden sources may include:

• Poor sleep quality

• Blood sugar imbalances

• Emotional suppression

• Over-scheduling and lack of rest

• Environmental overstimulation (noise, light, digital exposure)

SunSmart strategy:

• Slip on protective clothing

• Slop on broad-spectrum sunscreen

• Slap on a wide-brimmed hat

• Seek shade during peak sun hours

• Slide on UV-protective sunglasses

• Slide on UV-protective sunglasses—but skip metal frames, which can reflect sunlight onto the cheeks and nose, common melasma hotspots

  
  

  Treatment Options

  
  

  While melasma has no definitive cure, there are numerous effective treatments that can help reduce its appearance and manage flare-ups. With a consistent, tailored approach, you can see significant improvement in tone, clarity and overall skin health.