Thanks to multiple childhood summers spent at the Jersey Shore (Stone Harbor, no Snookie) and genetics, I’ve been permanently stamped with a liberal sprinkling of freckles across the bridge of my nose and the apples of my cheeks.
While no stranger to insecurity, for most of my life the freckles didn’t bother me because there wasn’t much I could do about them, just like being short or having brown eyes. Besides, it made me a little…unique.
Until my last trimester of pregnancy when my freckles unionized against me into one nasty uni-splotch on either cheek. On top of my 55 lbs of baby weight gain, I now had the complexion of an appaloosa.
Most of my melasma faded post-partum, but faint patches creep up on now and then, especially if I’ve been outdoors (even though I’m a sunscreen-wearing-wide-brimmed-hat person). Complicating this is that because I’ve had a lifetime of freckles, it’s tough to tell the difference between where the freckle ends and the melasma begins. Add to that the errant age spot.
What I didn’t know at the time, is that some of the treatments used to get rid of freckles can actually make melasma worse. Further, melasma tends to get worse overtime, especially if you’re not in the habit of smothering yourself in sunscreen. This is why it’s important to see a board certified dermatologist for a correct diagnosis. Often, the difference can only be detected by a Woods Lamp, that blue light the dermatologist scans your body with during skin checks.
Until you get to your dermatologist though, here are the crib notes on what you need to know:
First, all freckles, age spots, brown spots left from acne and melasma fall under the dermatological umbrella of hyperpigmentation, which is doctor speak for spots of abnormal darkening of the skin caused by excess melanin. Too much sun plays a role in all hyperpigmentation, but hormones are the culprits with melasma, either from pregnancy, birth control pills or if you’re in menopause hormone replacement therapy (HRT).
Freckles are small, brown flat dots. Most if the time they’re caused by both genes and too much sun. On the upside, these are pretty easy to treat because they’re closer to the surface of the dermis. They’re more apt to look like evenly distributed sprinkles and if they bother you, they can be easily treated with lasers, peels, and some skin care products. Here are some examples of what freckles look like:
Melasma on the other hand looks like concentrated patches of brown that congregate around your cheeks, forehead, upper lip or jaw. While sunlight stimulates melasma, the root cause are the hormones mentioned above. Also, women with darker skin tones (Hispanic, African American, Latin, Asian, Mediterranean, Middle Eastern, Indian, etc) tend to be more vulnerable to melasma. Here’s what melasma looks like:
Treating melasma is tough because unlike the freckle, the pigment is down deeper into the dermis so a lot of the topical creams won’t reach it. But there is hope beginning with a trip to a board certified cosmetic dermatologist who has an arsenal of weapons to treat. Dr. Brandith Irwin of Skin Tour says:
“Sunscreens, hydroquinones, antioxidants, and other topicals are still the mainstay of treatments, often combined with light peels or microdermabrasion. Lasers often make melasma worse”.
Here are some of the treatment options you and your doctor might discuss:
As for me, I’ve kept my melasma under control with a cocktail of sunscreen (I like Skin Ceuticals Total Fusion Physical Defense SPF 50), a wide brimmed Eric Javitz sunhat, sunglasses, prescription Retinol 1% during the winter and chemical peels every 6-8 weeks, alternating between Vitalize and Bx-Lift in the summer, and heavier peels like TCA or Vi Peel in the winter.
Coming up later this week, chemical peels in depth.
Do you have hyper-pigmentation of any kind, and if so where is it on your beauty pain scale and how do you treat it?