Identifying the dark spots

How do I know if I have melasma? 

When is a freckle more than a freckle? Well, there are a few clues. If it’s broad, patchy, or pancake-shaped, located on the forehead, chin, or upper lip, and it darkens or spreads over time, it just might be melasma. When I first noticed my melasma, it started with a very faint patch on my forehead. Soon after, it got darker and seemed to “spread” to my cheeks. At its peak, it appeared on my upper lip too. That’s when I knew the changes in pigmentation were more than a minor skin issue, and I set out to learn what was causing it.

So what is melasma really? Melasma is a harmless form of hyperpigmentation that can be triggered by changes in hormone levels as well as exposure to UV light. When melanocytes, the cells responsible for making pigment in the skin, become overstimulated, they produce an excess amount of pigment and release it deep into the layers of the skin. That’s what’s happening when you see pigmentation changes as a result of melasma.

If your dark spots usually appear symmetrically across both sides of the face and may change with the seasons, darkening in the summer months then it’s most likely melasma. UV exposure isn’t the only factor that can exacerbate it—any kind of visible light or heat can stimulate pigment production. In my own experience, I’ve found that the patchy areas on my skin can darken even when I haven’t been out in the sun. Spending time in hot environments like a hot yoga studio, using a blow dryer, and even looking at a phone or computer screen (blue light) for an extended period of time can aggravate melanocytes and lead to darker patches on the skin.

Science doesn’t have an exact explanation for melasma yet. While we have an idea of what causes its appearance and how it develops, there are still a lot of question marks. For this reason, there aren’t any hard and fast rules on how to prevent its appearance or how to know whether you might develop it at some point in your lifetime. No matter the case, avoiding direct sun exposure is an absolute must—not just for melasma prevention, but also to lower the risk of skin cancer and keep your skin looking smooth and healthy for as long as possible!

Genetics also seem to play a role in melasma development, which means that if someone in your family, like your mom or your grandma, has experienced this particular kind of hyperpigmentation, you might be more likely to notice it on your own skin one day. It’s possible that what triggered its development for your family member—sunlight, pregnancy, stopping or starting birth control, etc.—may trigger it for you as well.  

And while melasma isn’t only experienced by women, it’s much less common in men. It also affects certain ethnicities more than others. If you’re of Hispanic, African, Asian, or Middle Eastern descent, your chances of developing melasma are higher than those of a person of other racial origin. The reason for this is likely tied to the naturally higher levels of melanocyte activity in people of color. 

So, you’ve noticed a change in your skin. Is it melasma? Only a dermatologist can tell you for sure, but if the patches are broad and symmetrical, a member of your family has been diagnosed with it, you’re a person of color, and/or you’re often exposed to potentially aggravating sources of light or heat, there’s a strong possibility that the answer is yes. Don’t freak out! There are many solutions. It might be an uninvited guest on your summer vacation, but it’s not a disease or anything to be ashamed of.

In fact, the best way to address melasma isn’t to attack it like a problem, but rather to approach it with care and as an indicator that something is irritating your skin. Think of it as a helpful clue to a mystery your body wants you to solve—what’s overstimulating your melanocytes? Are you experiencing inflammation and hormonal shifts? Have you changed your diet recently? It may be time to skip the sunbathing and switch to clean spray tans. 

The development of melasma might just be the springboard you need to leap into a season of self-discovery and self-care. It’s tempting to try to minimize the appearance of dark patches with creams and depigmenting agents, but topical treatments don’t address internal triggers. Plus, procedures like lasers can exacerbate melasma rather than diminish it.

Remember, we’re all in this together!