by Jillian Ruffo
view feature on People.com
If you’re pregnant, on birth control pills or spend a lot of time in the heat or sun, there’s a chance you have or will experience a pesky skincare problem called melasma, a series of large brown spots on your face that are tricky to get rid of. The good news? You’re not alone in the struggle, and with the right products and strategy, you’ll have a clear complexion in just a few months.
Case in point: When Good Morning America’s Ginger Zee noticed the spots after her pregnancy, she turned to dermatologist Dr. Whitney Bowe to help her get rid of them. And now, after sharing her skincare success story on GMA, Dr. Bowe is filling us in on her secrets. Below, learn everything you need to know about the skin issue from Dr. Bowe.
What is melasma?
“Melasma consists of tan to brown patches that occur primarily on the forehead, temples, cheeks and the upper lip. It’s affects up to 70% of pregnant women, and is extremely common among women of color. Melasma tends to be appear as larger patches which may have jagged borders, and can look like a map, a mask, or that somebody took brown paint and splattered it on the skin.”
What causes it?
“Hormones play a major role in melasma. Ginger noticed hers during her pregnancy — about half of all cases begin during pregnancy. But birth control pills can trigger melasma also. Melasma occurs much more commonly in women as opposed to men, specifically because hormones are such a key factor.”
“Aside from hormones, UV exposure is really the strongest factor, and the number one reason why melasma treatments fail. If you don’t have strict avoidance of sunlight, no matter what your treatment is or how good it is, you’re doomed to fail.”
Will staying out of the sun make it fade?
“If you have melasma, it’s not just about wearing sunscreen. It’s about wearing a hat, trying to avoid direct sunlight between the hours of 11am and 2pm, and using SPF 50 or above. If it’s a cloudy day, you’re still getting a significant amount of UV rays coming through the clouds. If you’re in the car, UVA rays are going to come through the window. If you work near a window, you’re getting UV exposure all day long. If you have melasma, you’re wearing sunscreen whether you’re indoors or outdoors, whether it’s winter or summer, you have to be wearing it year round, and ideally reapplying it during the day with a Colorscience SPF brush or a spray that you can layer over your makeup.”
So all I need to do is wear sunscreen?
“No. Another trigger is heat. So hot yoga, saunas, steam rooms, cooking – if you’re in and out of the oven, that can trigger it. Any exposure to heat can make melasma worse. Infrared beds and infrared saunas, they also create heat. Basically if you feel warmth on your skin, it can trigger melasma. You have to be really careful.”
Is it genetic?
“Family history definitely plays a role in melasma, so if anyone in your family has struggled with it, you’re much more likely to get it.”
How do you get rid of it?
“You want to be really gentle when It comes to melasma. It’s all about a slow and steady approach. In people who have melasma, the pigment cells are exquisitely sensitive. Any injury to those cells, and they’ll start pumping out melanin which will stain the skin, which is why less is more. For Ginger, I used a combination of in-office treatments, prescription medications and and over-the-counter skincare. I rotate through a series of superficial peels, using different ingredients like glycolic acid one time, salicylic acid the next, and resorcinol every 3-4 weeks, and it’ll slowly lift the pigment out of the skin.”
“Number two, I customize a melasma emulsion. I select a blend of prescription strength ingredients, and recommend putting them on the brown spots only a couple times a week. I mix Retin-A, kojic acid and hydroquinone, which is the most powerful lightening ingredient and has to be used under very close supervision by a doctor”
“And then there’s the daily skincare regimen. With Ginger, she uses a gentle cleanser like Cetaphil (wash with fingertips only, meaning scrubs or exfoliating devices) in the morning, then an antioxidant serum like a few drops of Skinceuticals CE Ferulic mixed into a La Roche Posay sunscreen for her morning regimen. The antioxidants neutralize free radicals that are thought to trigger melasma. Every other night, she was using the melasma emulsion, and on the other nights she used CE Ferulic.”
“I also told her no hot yoga, saunas, steam rooms, sun bathing, tanning salons. She wore a hat when she was walking outside.”
Do lasers help?
“Ginger used to do hot yoga, and originally saw a dermatologist who recommended she use lasers to get rid of her melasma, which is actually one of the biggest myths around it. A lot of people think the more powerful the laser the sooner they’ll see results, and it’s the opposite. If the laser is too strong or creates too much heat, it can make your melasma worse. Photo facials are one of the worst things you can do for melasma, but a lot of people think it’s the best thing. I’ve seen melasma be made so much worse because people think all brown spots are created equal, and your brown spots will get better, but most people get worse. I would say avoid lasers altogether.”
Can I fight it without seeing a dermatologist?
“Yes. You want to look for ingredients with Vitamin C, kojic acid, licorice or soy – there are a lot of brightening ingredients out there. And then you have to be really, really careful about your sunscreen. You can use all the right lightening ingredients, but if you’re not using SPF, you’ll be fighting an uphill battle.”
Is it true that DIY treatments with citrus will help?
“No. If you Google home remedies for melasma, you’ll find all these recipes with lemon, lime, or orange juices, which can absolutely make your melasma 100x worse. Do not use lemon juice in a home remedy.”
How long does it take to go away?
“It takes time. I always tell people it’s going to take at least three months to lighten it. We can’t cure it – we can keep it under control – but there’s no cure, so it’s a lifelong commitment to your skin.”