Effective hyperpigmentation Management:

1. Utilize Mineral Sunscreen:

• Chemical sunscreens are absorbed into the skin and absorb UV rays, Mineral sunscreens (what you need for melasma) also known as physical sunscreens reflect UV rays. Mineral sunscreens contain ingredients such as Zinc Oxide and Titanium Dioxide. Chemical sunscreens contain ingredients such as Oxybenzone, Avobenzone, Octinoxate. I also go with a tinted mineral sunscreen because these also block blue light (from cellphones, computers). There are mixed studies on whether blue light affects melasma but growing research suggests that it does. These provide effective protection against harmful UV rays and are gentle on the skin. Best Mineral sunscreens for melasma.

2. Consistent Sunscreen Application:

• Reapply sunscreen every two hours, and if spending extended periods outdoors, consider reapplication every hour. Even the best mineral sunscreen cannot protect against 100% of uv rays so if you’re outside for extended periods of time wear a wide brimmed hat in addition to your mineral spf.

• Avoid peak times of sun 10am-2pm and seek shade when possible (even if you’re wearing SPF)

3. Dietary Changes For Melasma

• Opt for a clean and balanced diet. Minimize alcohol intake, as it can trigger melasma. A nutritionally rich diet supports overall skin health.

• I have learned over the years that processed foods flare up my melasma. Some researchers suggest that overgrowth of bad gut flora contributes to melasma as well so you can consider probiotics. Also, when I’m not within a healthy weight my hormones go wacky which flares up my melasma.

4. Essential Vitamin and Hormone Checks:

• Regularly check vitamin D, B12, Iron levels and thyroid levels. Imbalances in these areas can contribute to melasma. Identifying and addressing deficiencies is crucial for effective management

• Studies really aren’t great in this area but I will tell you once I started Vitamin D supplementation ( I was deficient) my melasma did slightly improve. I became a bit of a vampire and avoided the sun at all costs when my melasma first appeared so I’m sure this contributed to my D deficiency but nonetheless it’s worth checking

  This is not medical advice, please do not start any of these without discussing with your doctor or nurse practitioner. Taking a supplement without medical supervision and or taking too much of a supplement can be very harmful to you

5. Incorporate Lightening Agents and Retinol:

1. Explore tyrosinase inhibitors such as niacinamide, vitamin C, kojic acid, tranexamic acid, retinols, or hydroquinone. My favorite hydroquinone product is compounded by Musely. These ingredients are known for their potential to lighten pigmentation and even out skin tone. These are some of my favorite lightening products I’ve found.

2. If you are using Hydroquinone remember to take breaks. There isn’t great scientific evidence on exactly how long of a break you should take but many dermatologists recommend two months of HQ and one month off. I like to taper off my HQ to prevent severe rebound and taper as follows: On the last two weeks of my taper I alternate HQ and None HQ lightener every other day for a week, then HQ every 3rd day, then every 4th day and stop the HQ. Taking Hydroquinone breaks are important to reduce the chance of exogenous ochronosis. Exogenous ochronosis is rare, but possible and is characterized by dark blueish black spots.

3. Retinol, a form of vitamin A, helps with skin cell turnover so is incredibly important in melasma management. It helps slough off dead, hyperpigmented skin cells. It also has anti-aging effects, helps with acne and acne scars and reduces large pores. The best retinoid is prescription Tretinoin but you can also find retinol in many beauty products. If you are starting out with Tretinoin for the first time start with a lower strength (0.25% is a good starting point) and you may want to start a few times a week and slowly work your way up to every night. Retinol can be very drying and cause irritation and flakiness so pair with a good moisturizer for hyperpigmentation.

6. Professional Procedures:

1. Consider dermatologist-recommended procedures such as microdermabrasion, facials and chemical peels for melasma treatment. These can aid in reducing the appearance of melasma and promoting skin renewal. While some individuals have reported positive outcomes with Intense Pulsed Light (IPL) therapy and red light therapy, results can be unpredictable. These treatments have both helped and worsened melasma in different cases. Some individuals have found promise in Q Switch laser for melasma treatment. However, results can vary, and it is crucial to consider individual factors and consult with a dermatologist for personalized advice

7. Sun Protection During Commute:

• Extend sun protection to your daily commute by applying mineral sunscreen prior to leaving the office. Consider UV protective window tint for melasma which studies have shown block up to 87% of uv rays. This can significantly reduce your chance of worsening melasma, not to mention the skin cancer prevention benefits. Many states have regulations on the level of uv tint allowed however you can get a medical note from your provider for darker tinted windows.

• I remember at one point I was doing everything I could for my melasma and it was getting worse. Medical grade chemical peels, tyrosinase inhibitors, exfoliating regularly, mineral sunscreens but my melasma continued ot darken. Then it finally dawned on me I was not reapplying sunscreen prior to my commute home from work. i think I felt protected from the sun being in my car but the truth is quite a bit of sunlight comes through our windows.

• Reapply sunscreen right before your commute and if you’re on a road trip reapply every 1-2 hours. I usually use a hat and mineral SPF on a road trip.

8. Identify and Avoid Triggers:

1. Hormone fluctuations caused by birth control can be a trigger for melasma. Speak with your health care professional about alternative to hormones. Learn more about causes of melasma here.

2. Consider keeping a journal for when your melasma does flare up to try to identify triggers for you. If you wake up one morning and it’s darker think back to the day before. Did you drink alcohol, what foods did you eat? Were you exposed to the sun at any point in the day without sunscreen protection.

3. Ever notice that your melasma flares up with alcohol? There is definitely an internal component of melasma, the kinder you are to your body the better controlled your melasma will be

4. Avoid harsh products such as makeup remove wipes and cleansers containing alcohol

5. Avoid hot tubs, saunas and jaccuzis, the heat can trigger melanin production

9. High-Quality Makeup for Camouflage:

• Invest in high-quality makeup, concealer, and color correctors to effectively cover melasma. Look for products with good coverage and long-lasting formulas. Hyperpigmentation is a long, meticulous battle that takes patience and time so in the meantime having makeup coverage that helps with confidence can be so helpful.

10. Consistency is Key:

• Consistency in skincare routines and lifestyle adjustments is crucial for managing melasma effectively. Patience is key as improvements may take time. Often times with hydroquinone and other tyrosinase inhibitors melasma can darken initially before starting to fade so try not to get frustrated (and make sure you’re exfoliating those hyperpigmented dead skin cells!)

• Sometimes melasma flares up for no particularly reason, try to not get frustrated and keep consistent with prevention and maintenance

11. Don’t expect others to get it, even your dermatologist

• I once cried at a dermatology appointment (not ugly crying but cried, not one of my best proud moments) when my dermatologist condescendingly said to me ‘you must not be applying sunscreen as often as you say you are or it wouldn’t be worsening’. This was at a peak point of frustration in my melasma journey. She also told me melasma was purely external factors and internal factors (such as alcohol, processed food, stress, hormones) did not affect melasma at all which was completely untrue. At that time I had lived with melasma for at least 9 years so yes I applied mineral sunscreen constantly, had uv tinted windows in my car, hats for every occasion, she just simply did not get it. She had flawless, hyperpigmentation-free skin and couldn’t even begin to understand what someone with melasma goes through, the toll it takes on one’s self confidence. She sold me $400 dollars worth of products that actually worsened my melasma. She was a highly educated, very knowledgeable dermatologist but did not fully understand melasma, it’s it’s own beast. I had a previous dermatologist recommend a 2% hydroquinone formula that wreaked havoc on my melasma. Another dermatologist later told me hydroquinone less than 4% can actually worsen melasma. The takeaway here is that science does not fully understand all of the components of melasma and there is no one size fits all, so find the best regimen that you can live it and take it day by day.

Empower yourself with these practical tips for melasma management. Customizing your approach based on these recommendations can contribute to clearer, healthier-looking skin. Always consult with skincare professionals for personalized advice and tailored solutions.