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Causes of Melasma on Dark Skin Tones

by | Jul 19, 2024 | Info | 0 comments

Melasma Overview

Melasma is a common form of hyperpigmentation that causes dark skin patches to develop on the face and other areas of the body commonly exposed to sunlight.

Possible causes of melasma include sun exposure, changes in hormones, and skincare products that contain irritating chemicals. The dark patches develop as a result of malfunctioning melanocytes, the cells that produce color in the skin.

Females and people with dark complexions are at a higher risk of developing melasma. Although it is harmless, some people may seek treatment for aesthetic reasons.

Symptoms of Melasma

The symptoms of melasma look different depending on a person’s skin tone. In general, melasma causes patches of dark skin on high points of the face.

Melasma on dark skin appears as dark brown or grey-brown patches. These patches often appear in a symmetric pattern on both sides of the face.

These patches often appear on the:

  • Cheeks
  • Nose
  • Forehead
  • Upper lip
  • Chin

These patches can also appear on other parts of the body that a person exposes to the sun, such as the:

  • Arms
  • Chest
  • Neck
  • Shoulders

The patches usually have irregular borders. Some patches form flat solid patches of discoloration, while others have a freckly or blotchy appearance.

Causes of melasma on dark skin

Melasma occurs when melanocytes produce too much pigmentation in the skin, resulting in dark patches. People with black or brown skin have more melanocytes. This means that they are more likely to develop melasma than people with lighter complexions.

This condition usually develops in adults in their 20s or 30s. However, some forms of melasma do not appear until a person reaches their 40s.

Melasma occurs more often on female skin than on males. According to the American Academy of Dermatology (ADD), only 10% of people with melasma are male.

Possible causes of melasma include:

  • Frequent sun exposure
  • Hormonal changes that occur during pregnancy or while taking hormonal birth control
  • Genetics
  • Skincare products that contain irritating ingredients


Hormones

Melasma due to hormonal changes will fade once hormone levels return to normal. This can happen after pregnancy ends or once a person stops taking hormonal birth control.

Certain medical conditions can cause hormonal imbalances. Examples include:

Treating an underlying hormonal imbalance may help improve melasma symptoms.

Diagnosing Melasma on Dark Skin

Melasma causes distinctive skin changes that most doctors or dermatologists can identify easily. A doctor may use a Wood’s light to see how far melasma has penetrated the skin.

Melasma can resemble other hyperpigmentation conditions. A doctor may order a skin biopsy to rule out other diagnoses, such as melanoma or dermatitis.

Treatment of Melasma on Dark Skin

Melasma does not typically require treatment. However, some people may seek treatment for aesthetic reasons. While various topical agents and cosmetic procedures can help fade melasma patches, not all treatments work for everyone.

Treatment might not completely clear melasma patches, and melasma can return even after successful treatment.

Since sun exposure can contribute to melasma, people must wear sunscreen to protect their skin and prevent melasma flares.

Treatment options for melasma include the following:

Creams

Topical creams and gels are the first-line treatment options for melasma. Hydroquinone is a topical medication that lightens the skin.

This cream is only available as a prescription through your doctor. Previously it had been available over the counter but the status was changed in 2021 following a ruling by the FDA.

Although hydroquinone can help improve the appearance of melasma patches, it can cause side effects.

Side effects of hydroquinone include:

  • A burning or tingling sensation
  • Blue-black discoloration 
  • Dry skin
  • Inflammation

People can use hydroquinone alone or in combination with other topical therapies.

In a 2015 study, researchers randomly assigned 233 participants a cream containing hydroquinone,  fluocinoione acetonide, and tretinoinTrusted or a placebo cream. After 8-weeks of daily use, the combination cream was 64.60% effective, and the placebo was 0.88% effective in treating melasma in Chinese people.

Other topical agents that may improve melasma include:

Laser Therapy

If hydroquinone and other topical therapies do not improve melasma, laser and light-based treatments may help. Laser therapy does not affect melanocyte activity. Instead, it removes pigmentation from the skin.

Unfortunately, laser therapy can cause post-inflammatory hyperpigmentation and lead to rebound melasma flares. It is best to use laser therapy alongside topical treatments.

Medical Procedures

Medical procedures may help fade melasma patches if topical treatments do not work. These include:

  • Chemical peel. A chemical peel uses glycolic acid to promote rapid skin cell turnover. This procedure may help remove discolored skin cells.
  • Microdermabrasion. Microdermabrasion is a form of physical exfoliation. During the procedure, a doctor uses an abrasive tool to remove the outer layer of skin.
  • Microneedling. During microneedling, a dermatologist pricks the skin with a very fine needle. According to a 2017 pilot study, microneedling helps stimulate collagen production, and it can even improve melasma and other hyperpigmentation disorders.


Changes in Diet

While topical treatments are effective, some people may wonder if they can treat melasma through diet and lifestyle changes. Currently, there are no known foods that improve or exacerbate melasma.

But the authors of one 2017 systematic review found evidence that suggests oral medications and dietary supplements are effective treatments for melasma. The specific dietary supplements cited in this review include beta carotene and procyanidin.

Beta carotene is a red-orange pigment found in colorful fruits and vegetables, such as:

  • Broccoli
  • Carrots
  • Grapefruit
  • Pumpkin 
  • Sweet potatoes
  • Grapes

Procyanidin is another plant compound commonly found in:

  • Apples
  • Blueberries
  • Cranberries
  • Grapes
  • Strawberries

Prevention of Melasma

While melasma is treatable, people can take steps to prevent melasma. These steps include the following:

  • Avoiding direct sun exposure
  • Eating a healthful, balanced diet
  • Maintaining a healthy weight
  • Wearing broad-brimmed hats outside
  • Using gentle skincare products
  • Managing any underlying health conditions
  • Wearing sunscreen daily


Summary

Melasma is a common pigmentation disorder that causes dark patches to form on the skin of the face and upper body. It occurs when specialized skin cells, called melanocytes, produce too much pigment.

People with dark skin have more melanocytes and have a higher chance of developing melasma. Melasma on dark skin causes dark brown or grey-brown patches.

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