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The Best Treatments for Melasma

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While interviewing a dermatologist for a story last year, I shamelessly took the opportunity to ask about something that had been bothering me. “What is this on my forehead?” I asked, pulling my hair back. He leaned in to inspect my brown-speckled skin. “It looks like melasma,” he said.

The dark spots on my face had only appeared a few years earlier. I thought back to a hiking trip I took in my 20s; I’d made sure to wear sunscreen, since I knew I’d be at a higher altitude in the mountains and that the sun would be strong. But I forgot to reapply, and ended up sunburned. Ever since, I’d been plagued by these brownish-gray patches.

According to New York-based dermatologist Rachel Nazarian, MD, you can develop these annoying brown spots on your skin at any point in your life, but they can suddenly crop up in adult women due to changes in hormones. Below, we asked dermatologists for their best tips to treat and prevent skin pigmentation caused by melasma.

What is melasma?

Melasma is dark brown or gray discoloration of the skin that typically affects sun-exposed parts of the face, such as the forehead, cheeks, and upper lip. The greater the baseline melanin is in skin, the more likely you are to experience melasma—which means those with darker skin tones are more likely to have it, says Dr. Nazarian.

Certain health conditions can also make you more sensitive to sunlight and more prone to developing melasma, Dr. Nazarian explains, such as thyroid problems and being on birth control pills. It’s also thought to be hereditary, she adds, so if one of your parents has melasma, you might develop it, too.

Pregnancy can up your risk as well. In fact, melasma is often referred to as the “mask of pregnancy” and can occur in up to 50% of pregnant women, Debra Jaliman, MD, a New York City-based dermatologist, tells Health. Because hormones change during pregnancy, skin is more sensitive to sunlight, which can cause your complexion to go from clear to a little spotty.

Prevention is seriously easy

To avoid melasma (or at least control dark pigmentation you already have), the best preventative measure is to use SPF on your face every single day, rain or shine. A few derm-approved favorites include EltaMD UV Clear Tinted Facial Sunscreen Broad-Spectrum SPF 46 ($35; amazon.com), Neutrogena Ultra Sheer Dry-Touch Sunscreen SPF 55 ($12; amazon.com) and Drunk Elephant Umbra Sheer Physical Daily Defense Broad Spectrum Sunscreen SPF 30 ($34; sephora.com).

It’s smart to avoid too much sun and heat, but if exposed, be sure to cover with a wide-brimmed hat. As I learned firsthand, melasma can crop up from sunburn. Dr. Nazarian points out that some oral medications and supplements, such as Heliocare ($19; amazon.com) may make you less sensitive to sunlight and, if taken daily, could lessen your chances of getting melasma. 

Best treatments for melasma

Once you have them, it can be challenging to rid yourself of these freckly brown spots. Melasma rarely goes away on its own, experts say, but there are treatments you can try to ease their appearance.

In addition to wearing sunscreen religiously, Dr. Jaliman says products that contain niacinamide (vitamin B3), a potent antioxidant, can help even skin tone. Try InstaNatural Niacinamide 5% Face Serum ($15; amazon.com), which boasts niacinamide and ultra-moisturizing hyaluronic acid.

Also good: Vitamin C inhibits an enzyme called tyrosine from converting into melanin (the pigment that darkens skin), so skin gets brighter. Investing in a topical vitamin C serum can help improve dark discoloration. We like Mad Hippie Vitamin C Serum ($28; amazon.com).

It may require a combination of different treatments, but getting rid of melasma is not impossible. If you aren’t having luck with topical treatments, book an appointment with your dermatologist to learn more about in-office procedures. Dr. Nazarian recommends Vi Peels (a chemical peel) and light treatments such as IPL combined with resurfacing lasers such as Fraxel to combat melasma.

“These [treatments] should only be done by a board-certified dermatologist, as they have the risk of making melasma worse if not done properly,” Dr. Nazarian warns. She stresses the importance of continuing to wear a high-SPF sunscreen and avoiding heat to prevent reoccurrence.

How best to conceal melasma

When I first started noticing darker pigmentation in my forehead, I found myself a little self-conscious. What began as severe sunburn faded into grayish spots that made me look, well, old. But I’ve since learned that there are a few affordable and effective ways to conceal dark pigmentation caused by melasma.

Dr. Jaliman suggests trying over-the-counter products with ingredients like kojic acid, licorice extract, topical vitamin C, white mulberry extract, or bearberry extract, which all work to lighten skin and improve dark discoloration. Tinted moisturizers and sunscreen primers provide good melasma coverage (try It Cosmetics Your Skin But Better CC Cream, which is has an A-list stamp of approval from reality star Whitney Port).

For more severe dark spots, consider makeup from CoverFx to camouflage discoloration. Dr. Nazarian likes CoverFX Power Play Foundation ($44; sephora.com), because it works well to cover many skin conditions, including melasma.

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