Is There a Cure for Melasma? Is it self-limiting? What about pregnancy?

HI Dr. Irwin, I'm 26 and about 2 years ago, I noticed discoloration near my eyes. When I went to Mexico, my mom noticed it (now, I know that the sun exacerbated it). It reduced in the winter months, and was almost unnoticeable. I use SPF 70 every day, try to limit sun exposure as much as I can, wear a hat often, but not always, when I'm outside, use turmeric face masks to help in the fading, and use Meladerm every day (have been using it for 3 months now, 2x daily). I have been off of birth control for 8 months now and I haven't seen too much improvement I'm wondering is melasma self-limiting and thus will fade in due time once birth control has stopped? Does this mean that when I am pregnant in the future that I have a higher likelihood of getting melasma again? How long should I anticipate it should take before this fades? Are there certain foods I should avoid eating. Thank you for your help!!

Great questions since there are many myths about melasma!   Also, it’s one of the most frustrating skin problems for patients and doctors because there is no true cure ….yet!   There’s just great control.    In answer to the above:

  • Remember it’s a combination of female hormones and sun.   The sun part is the most controllable and UVA (not B) is most important.  You must use high zinc sunscreens and double or triple sunscreen the area in high sun situations.
  • “Bleaching” creams have usually a temporary effect and the problem often recurs after stopping them.  See link to a good melasma skin care regimen.
  • If you’ve had melasma In the past, pregnancy almost always makes it worse.  Be extra careful and always wear a brimmed hat.   First time melasma with pregnancy will sometimes fade close to completely if not aggravated with sun.
  • There are no foods that we know of that help (wouldn’t it be great if there were?:))
  • Lasers except in expert hands are not a good idea.   The problem often get better initially and then worse again.

More on melasma!

Hope this helps!  Dr. I

Dr. Brandith Irwin, MD

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