The Nurx medical team looks into it many of photos of faces — the faces of our patients requesting treatment for acne, sun-related aging, and rosacea. But they noted that many of these images also revealed signs of melasma, a skin condition characterized by patchy dark spots and discoloration, often caused or exacerbated by sun exposure and hormonal fluctuations. It’s no surprise that so many Nurx patients experience melasma, as it’s common in women 20-40, which pretty accurately describes the Nurx community.
So to offer you specialized solutions to this common skin condition, we’ve launched melasma treatment, which includes comprehensive online testing, personalized prescription plans, medication delivery and ongoing care
To help you learn more about melasma and understand if the treatment is right for you, we turned to Dr. Marie Leger, a dermatologist and one of the Nurx clinical advisors who created our melasma treatment plan. Read on for her expert answers to this common skin condition.
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What causes melasma, and why are some people susceptible to it?
Melasma is most common in women of reproductive age with medium to medium dark skin, and has a hereditary component — half of people with melasma report having a relative who also experienced the condition.
It may first appear as a result of sun exposure or hormonal fluctuations, such as those experienced during pregnancy or if you use birth control that contains estrogen.
How do you treat melasma?
The gold standard, the best-studied treatment is topical hydroquinone cream. Hydroquinone is a tyrosinase inhibitor, which blocks an enzyme to reduce the production of melanin in the skin. After 2-3 months of consistent use you should see a significant improvement in melasma.
In rare cases, long-term use of hydroquinone can cause something called ochronosis, which inversely darkens the skin and can be permanent. This is often reported with use longer than six months so to be cautious we only prescribe a three month supply of hydroquinone in Nurx. After three months, we’ll switch you to a maintenance treatment, usually azelaic acid or tretinoin. Both of these can also improve melasma. After you take a six-month break from hydroquinone, we may prescribe you another three-month supply.
Are other treatments effective?
There are many over-the-counter products that can help with melasma as well. Look for ingredients like kojic acid, vitamin C, and licorice extract. But, there are also many over-the-counter “skin whitening” treatments that are ineffective or even dangerous—such as those containing powerful steroids that are not legally available in the United States. Avoid those products, and don’t try harsh treatments like alcohol or scrubs. Many of these products can make hyperpigmentation worse!
Everyone wants the magic laser to get rid of melasma, but in some cases laser treatment can make it worse so you have to be careful. If you’ve reached a point where you’re not seeing much improvement with current treatment or where you want to explore the kinds of options that are only available in person, we’ll refer you.
What lifestyle changes can help?
I can’t emphasize tinted sunscreen enough! UV light and visible light can both make melasma worse. Sunscreen protects (both physical and chemical blockers) against UV light, and tinted sunscreen in particular protects against both UV and visible light. The best sunscreen is the one you use. Find one you like and use it every day, and aim to reapply every two hours if you’re in the sun. Hats are also very helpful. If you are pale, you are getting too much sun. Melasma is recurring—you can improve it with diligence and care, but if you forget sunscreen, it can flare up and derail your progress.
Melasma is common during pregnancy and hydroquinone is not safe during pregnancy or breastfeeding. However, there are safe ways to prevent and treat melasma during pregnancy, such as sun protection and azelaic acid, and pregnancy-related melasma usually improves a few months after giving birth.
If you suspect that birth control is making your melasma worse, ask your medical provider to discuss whether a formula with less or no estrogen might be a better choice for you.
Is there a cure for melasma?
Melasma is a chronic condition, but we can significantly improve it with proper treatment and by avoiding sun exposure. But don’t despair — with hard work and persistence we often find it gets better! The Nurx medical team is here to help—and again…SUNSCREEN!
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Interested in getting melasma medication prescribed online and delivered to your door? Request melasma treatment today!
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely on the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
