We are all aware that exposure to the sun triggers changes in our skins’ pigmentation and can increase our risk of sun cancer. This makes regularly checking our skin and seeking expert advice if we are in anyway concerned by changes in the colour (or shape, size, feel or elevation of a spot on our skin), the absolute bedrock of skin health, which could save our life.
While sun damage can lead to cancerous changes in our skin, it can however, also lead to a common, harmless alternation to our skin’s pigmentation, known as ‘melasma’
What Is Melasma?
Melasma are dark, greyish-brown, freckle-like areas, less than one centimetre across which develop on our skin. Unlike moles, melasma are not raised and most commonly affect our face, especially on our cheeks, forehead, and upper lip. They may also appear on our upper arms and shoulders and once over 50 years of age, on our neck as well.
Melasma is caused by the pigment producing cells in our skin called ‘melanocytes’, making more dark pigment than usual. It is comforting that melasma cannot turn into cancer but uneven patches of pigmentation, especially on our face can feel upsetting and so It is good to know, that there are steps we can take to both reduce the risk of development of melasma in the first place as well things we can do to help patches to fade.
Who Is Affected and What Causes Melasma?
Expert skin doctors explain that while melasma tends to be more common in Mediterranean, Indian, East Asian, Pakistani, Middle Eastern, Hispanic-American, and Brazilian populations, it can affect all skin types, 90 per cent of which, are women.
Long term and on-going exposure to the sun is a major cause of melasma but it is associated too with high levels of the female sex hormones oestrogen and progesterone. This helps to explain why melasma is particularly common during pregnancy and in women taking oral contraceptives containing these hormones.
There are in addition, a surprising array of other causes, which have been identified, some of which we can manage in our daily lives, including say experts, exposure to the LED lights from our phones, laptops, tablets and televisions, the use of certain cosmetics that cause phototoxic reactions, some scented soaps and skin care products and tanning beds.
In addition, there are some medicines that can make us more sensitive to sunlight and more prone to melasma, including certain antibiotics, diuretics and some blood sugar lowering and nonsteroidal anti-inflammatories drugs. If you experience melasma and know you are taking any of these medications, it is worth speaking with your doctor to review your treatment plan.
Dermatologists also recognise melasma may be triggered by a deficiency of vitamin B12. People following a vegan lifestyle need to be particularly vigilant around B12 because it is only found in animal-based foods. This makes either eating B12 fortified foods daily or taking a regular B12 supplement, crucial. It is important as well to appreciate that we find it harder to absorb vitamin B12, as we move into our fifties and beyond. A simple blood test can identify a lack of this nutrient and be corrected by regular supplementation and in some cased, injections of B12. A lack of the B vitamin folate can also be a cause and so checking on blood levels of this nutrient and correcting if low can also be part of a correcting melasma.
How Can We Improve Melasma?
Before dealing with the uneven pigmentation of melasma on our skin, it is important to ensure that other skin problems such as eczema, dry skin or acne are being successfully managed. It is vital too, to remember that time is an important part of the process and that using natural skin products and cosmetics can also be part of a well-rounded approach to reducing the appearance of melasma pigmentation on our skin.
The first step is to do all we can to stop melasma getting worse and daily application of sunscreen is a vital part of this process. Dermatologists with an expertise in melasma recommend applying sunscreens containing zinc oxide and with an SPF of 30 to 50, every two hours. Staying out of the sun and wearing a wide brimmed hat are other age-old recommendations to prevent sun damage generally and these preventative habits very much apply to melasma as well.
Some of the pigments in melasma patches, formed in the top layer of our skin, can be removed by literally peeling them off. Certain traditional peel ingredients can however be harsh, leaving irritation and redness in their wake. Turning to products, which contain natural yet highly effective ingredients, such as alpha hydroxy acid and salicylic acid make a helpful alternative.
Before a peel, it is crucial that our skin is thoroughly cleansed. Achieving a thorough cleanse, while introducing active ingredients that will support our skin for the peel to come, is a sensible approach. Looking therefore for cleansers that deliver a range of antioxidants as well as calming, soothing ingredients makes an ideal combination. Alpha-lipoic acid, vitamin C and E are potent antioxidants while lavender extracts are naturally calming and soothing.
The aim of creams, serums and masks, are to introduce ingredients that help to slow down the production of melanin in melanocytes in the deeper layers of our skin, as well as to support the production of new, healthy skin cells.
In mainstream cosmetics, reducing melanin production is achieved through adding hydroquinone, but this ingredient can come with unwanted side effects. Similar and in some cases, more effective results can be gained through using natural plant extracts found for example, in aloe, geranium, and citrus fruits.
Extracts from mulberry, bearberry and liquorice have also all been studied for their melanin-suppressing capabilities. Vitamin C based compounds, extracts of green tea and soybean as well as kojic acid (from fungi) and ellagic acid (from fruits like grapefruit and grape stem cells, and nuts) have also been shown to reduce melanin production, which in turn, can help to reduce melasma pigmentation.
The same is true for niacinamide, an active form of vitamin B3 found in yeast and root vegetables. In addition, research indicates that curcumin, the active plant compound in the spice turmeric, also can help to reduce melanin production in human skin cells. Finally, come retinoids, which appear to affect melanin production at several points in its synthesis in our skin’s melanocytes.
Retinoids have the additional role of helping other active ingredients like kigelia, hibiscus and calendula, in masks, serums and creams, which support the growth of new, healthy skin cells, to penetrate successfully into our skin’s deeper layers.
Registered Nutritionist AFN
PG Dip Dietetics,
Associateship King's College (AKC)