"The groundwork of all happiness is health." - Leigh Hunt

A mask that is difficult to shed.

Since the beginning of the pandemic, lots of us have pondered the professionals and cons of masks. Yet there may be one other sort of mask that has been around for a very long time but isn't really easy to peel off. It's called melasma, and 90 percent of ladies suffer from it, in line with the American Academy of Dermatology.

Melasma isn't harmful, but its stubborn patches (formally generally known as hyperpigmentation) can actually cause emotional distress, says Dr. Korosh. And some melasma is so severe that it could't be covered with makeup. “Patients have told me their melasma is ruining their lives,” she says. “Some isolate themselves and don't want to go out in public because they feel so spoiled.”

Insight into motivations

Hormonal fluctuations work along with other aspects, including genetics and darker skin tones, to make melasma more likely. But the predominant co-conspirator is the sun exposure. In recent years, scientists have also learned that ultraviolet (UV) light from the sun isn't the one wrongdoer, blue light from screens and devices also contributes to the event of melasma. Even prolonged exposure to heat (say, standing near an oven) or air pollution (equivalent to smog and automobile exhaust) can play a task.

“These harmful chemicals and pollutants can disrupt the skin's protective barrier and cause irritation that worsens hyperpigmentation,” says Dr. Korosh.

Certain medications, including some antibiotics and pain medications, could make us more sensitive to light exposure and aggravate melasma. That's why Dr. Kourosh rigorously reviews a patient's medical history when she diagnoses melasma, a process sometimes aided by devices that measure how deep the pigment is deposited into the skin. Is.

“It's a really comprehensive picture,” she says. “I need to rule out other problems that could be causing hyperpigmentation, including hormonal imbalances, drug reactions, or endocrine disorders.”

Tips to avoid flare-ups

Even with intensive treatment, melasma can easily return, but you may prevent this scenario with these steps.

Use sunscreen every day. Choose one with broad-spectrum protection labeled SPF 30 or higher. Even higher, mineral-based sunblocks protect your skin from UV rays in addition to all visible light.

Wear a wide-brimmed hat. “A multi-pronged approach to sun protection can make the difference in terms of who gets better from melasma and who doesn't,” says Dr. Erin Shadi Korosh, MD, a dermatologist at Massachusetts General Hospital.

Practice gentle skincare. Melasma just can't be cleared up, and satirically, skin cleansing products can irritate and worsen it. Avoid stinging or burning products, and avoid drastic hair removal efforts, equivalent to waxing.

Main cities and recent ways

Melasma may fade or disappear by itself, especially when the trigger — equivalent to a sunny vacation, pregnancy, or oral contraceptive use — goes away. But you shouldn't attempt to self-diagnose or treat melasma with out a dermatologist's input, says Dr. Korosh. If you're tempted to try an over-the-counter product that claims to lighten dark spots, you wish a health care provider's expertise on its safety and effectiveness.

That said, there are a number of basic treatments and newer treatments available. Options your doctor may recommend include the next:

Hydroquinone. This skin lightening agent is available in cream, lotion, gel or liquid form. It works by destroying excess pigmented skin cells.

Tretinoin and corticosteroids. Tretinoin is a retinol derived from vitamin A that increases cell turnover within the skin, increasing skin radiance when added to hydroquinone. Steroids can reduce skin inflammation. A “triple cream” (tri loma) may contain all three ingredients.

Acid-based lighteners. By adding azelaic acid, kojic acid, or other acids, these topical products gently exfoliate the highest layers of skin to cut back dark spots.

Tranexamic acid. Traditionally used to treat heavy bleeding, the drug has also been shown to be effective against stubborn melasma in recent times, says Dr. Korosh. But the pandemic has set back its use somewhat, as a possible side effect — blood clots — can be a complication of COVID-19.

Dr. Korosh also red flags chemical peels or laser procedures to treat melasma. Many “medical spas” advertise these techniques to lighten blemished skin, but they often employ staff without medical training who cannot guarantee results. “These procedures can do more harm than good by heating and inflaming the skin,” she says.


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