Melasma may not be a life-threatening condition, but it can sure as heck threaten your quality of life. 

Several studies have shown that melasma can have a negative impact on self-esteem. It’s no wonder you might feel a little panicked wondering “Why is my melasma getting worse?” 

The good news is that, for the most part, melasma isn’t a mystery, and there are some contributing factors you can address.

What Is Melasma?

Melasma manifests in different ways for different people and can vary based on skin color and even the time of year. Only a dermatologist should diagnose whether melasma is the skin condition you’re dealing with, but there are a few things to help you decide if you need to see a specialist for a diagnosis.

Melasma most commonly affects the face and forearms, causing them to become darker than the rest of the body. It appears as dark spots or blotches. Many pregnant women experience this, so it’s often referred to as the mask of pregnancy. It can also affect women who take oral hormones or contraceptives.

For years, melasma was associated with women, but men can develop this condition too. In fact, aside from some hormonal triggers, the causes are the same. Melasma most commonly affects men of darker skin tones, such as Black people, Asians and Hispanics. Caucasian men are the least likely to develop the condition.

What Are the Types of Melasma?

Melasma manifests in three main forms. Each type speaks to the depth of the pigmentation. A dermatologist may use a black-light bulb to determine the depth.

Epidermal

This type of melasma responds better than the other two to treatment. It has well-defined borders and appears fairly obvious under black light. This type tends to show as dark brown spots.

Dermal

If your melasma is bluish or light brown, then you might have dermal melasma. Its borders are more blurry and it does not show well under black lights. This type is less responsive to treatment.

Mixed Melasma

Most people have mixed melasma, which is a combination of the two. In these cases, patients have both dark brown and light brown or grayish-blue spots. They show as a mixed pattern under black lights and tend to respond to treatment.

What Triggers Melasma?

Causal factors are a good starting point when wondering why your melasma might be getting worse? Almost anything that causes melasma can make the condition worse.

Genetic Factors

Roughly 50% of people who develop melasma report a family history or belong to a high-risk demographic. While this does not worsen the condition on its own, it can make affected people more likely to suffer long-term from the condition. People who are predisposed may also react more severely to the same triggers.

Sunlight Exposure

People of light-brown skin tones who are frequently exposed to the sun have the highest likelihood of developing melasma. Scientists believe UV exposure causes the body to speed up the production of melanin to the point of excess. 

Thyroid Disease

There is a strong association between thyroid disease and melasma. People who have melasma are four times as likely to have thyroid disease. It’s not clear whether thyroid issues worsen the condition, but the two quite often coincide.

Hormonal Influences

Medical practitioners do not fully understand why pregnancy triggers melasma in so many women. One theory suggests that the high production of melanocyte-stimulating hormones, progesterone and estrogen could cause this in the third trimester. Men can develop hormone-triggered melasma after receiving hormonal treatments for prostate cancer.

Skin Routine

You might feel compelled to try certain cosmetic products to even out your skin tone. Exfoliating scrubs are among the most common, but these can actually make the problem worse. Melasma is a form of hyperpigmentation that can occur because of friction on the skin, so scrubbing can sometimes make it worse.

Will Melasma Cause Other Skin Conditions?

Melasma patients often worry that this skin condition may lead to developing something else. Luckily, studies have not associated melasma with any other skin condition. For the record, it also has no mortality or morbidity risks. 

In fact, people with melasma seem to have a much lower risk of developing melanoma.

That said, the desire to resolve melasma can lead some people to use products that irritate the skin in other ways. Be mindful of using multiple products or mixing them. One may counteract others, and even worse, when used together certain formulas could cause an adverse reaction. For example, some skincare products use alcohol while others use peroxide, two chemicals that shouldn’t mix. The combination could lead to catastrophic results if it occurs around the mouth or eyes.

What Can I Do To Get Rid of Melasma?

The good news is that melasma often resolves itself. This is especially true when it follows pregnancy or other hormonal triggers. However, this can take several months. If you know what triggered the condition in the first place, you can make lifestyle changes to reduce exposure to these risks. Instead of trying to do it all at once, pick one thing at a time so you can determine your root cause.

Once developed, melasma can return. What caused it the first time might not be what triggers it the second time or what makes it worse. Because of this, if you do seek treatment, expect to continue the treatment long-term, even if you only need to do so intermittently.

There are dozens of treatment options on the market, but what works for you will depend on the cause and your skin tone. Currently, one of the safest options for long-term management is the use of customized topical treatments that rely on topical solutions, with the help of a trained dermatologist. These substances generally include kojic acid and hydroquinone. Together with other ingredients, they deliver pigment-blocking power.

How Can You Get a Custom Melasma Treatment Plan?

Your skin and skin tone are unique, and your solution should be too.

Not all dermatologists have experience with melasma specifically. Research your local options as well as online dermatology providers like Nava MD. We treat common conditions like acne and wrinkles, and our dermatologists treat each case as unique, so you know you get a solution selected to work for you. To make things even easier, we deliver your prescription right to your door, so you never need to leave home.

It’s our goal to help men and women create and maintain healthy skin, affordably from home. Get started with an online consultation today.