Hormonal Pigmentation | Melasma | Skin Renewal Clinic | 6

Hormonal Pigmentation / Melasma

Melasma, also called hormonal pigmentation, is a persistent and complex skin condition that affects many South African women and, in some cases, men. It manifests as darkened patches on the face, often triggered by hormonal changes, sun exposure, and other environmental factors. While it can occur in any skin type, melasma is particularly prevalent among women with darker complexions and often requires long-term management.

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What is Melasma?

Melasma is a form of hyperpigmentation characterised by brown or greyish patches, commonly on the cheeks, forehead, and upper lip. The condition is often associated with hormonal changes, particularly during pregnancy, when using oral contraceptives, or undergoing hormone replacement therapy (HRT). However, other factors such as thyroid dysfunction, certain medications, and excessive sun exposure can also trigger melasma.

Common Skin Pigmentation Disorders

Freckles (Ephelides): Small brown spots appear after repeated sun exposure, especially in people with fair skin. These tend to darken in summer and fade in winter.
Age Spots (Solar Lentigines): Flat, brown or black spots caused by prolonged sun exposure, typically found on the face, hands, and arms.
Post-Inflammatory Hyperpigmentation (PIH): Dark spots that form after skin injury or inflammation, such as acne or eczema.
Albinism: A genetic condition causing a complete lack of pigmentation due to the absence of melanin.
Vitiligo: An autoimmune condition that leads to a patchy loss of pigmentation, resulting in irregular white patches on the skin.

Triggers of Pigmentation Disorders

Various factors can trigger pigmentation disorders like melasma. Hormonal changes, such as those experienced during pregnancy, the use of oral contraceptives, or hormone replacement therapy (HRT), are common contributors. Prolonged exposure to sun ultraviolet (UV) light can also worsen pigmentation. Additionally, certain photosensitising medications, including tetracyclines and some anti-psychotic drugs, can increase the likelihood of developing pigmentation issues.

Why Treating Melasma is Challenging

Melasma involves both superficial and deep pigmentation, treating it more challenging than other pigmentation disorders. It is often accompanied by underlying issues such as redness, sensitivity, and inflammation. This means treatment requires a comprehensive, multi-layered approach that addresses these root causes while managing pigmentation.

Skin Renewal's Doctor-Led Approach to Melasma

At Skin Renewal, we believe in a holistic, doctor-led approach to melasma treatment. During your initial consultation, one of our experienced doctors will assess your medical history, lifestyle factors, and skin condition to identify any underlying health issues contributing to your pigmentation. This personalised consultation ensures targeted treatment and addresses the condition's root cause.

Our comprehensive consultation process includes a physical examination and discussion of any external factors, such as hormonal imbalances, medications, or environmental exposures, which could exacerbate your condition. This thorough evaluation enables us to design a tailored treatment plan that offers the best results for your skin type and pigmentation severity.

The Importance of Combination Treatments

Melasma is a complex condition that often requires a combination of treatments for optimal results. At Skin Renewal, we combine various therapies to target different layers of the skin and address both superficial and deep pigmentation. This ensures that all contributing factors—vascular issues, redness, and inflammation—are managed effectively. This multi-pronged approach improves the appearance of pigmentation and promotes overall skin health.

Melasma treatments are customised based on the depth and severity of the pigmentation. Superficial treatments, such as chemical peels, Laser Genesis, PicoToning, and RF skin needling, focus on exfoliating and rejuvenating the skin to reduce pigmentation. For deeper pigmentation, treatments like PicoFractional, MesoBrite™ depigmenting mask, injected mesotherapy with Tranexamic Acid, and Dermapen skin needling with tyrosinase inhibitors are effective in targeting and breaking down pigmentation for long-term results.

Supplementation and Lifestyle Recommendations

For long-term management, we recommend daily use of a broad-spectrum SPF 50+ sunscreen, topical antioxidants such as Vitamin C and E, and essential supplements like glutathione and MSM to boost skin health and reduce pigmentation.

Skin Renewal Tips for Managing Melasma

Avoid excessive heat exposure, such as hot baths and saunas, which can worsen inflammation and pigmentation.
Use a daily tyrosinase inhibitor to prevent new pigment production.
Apply broad-spectrum sunscreen (SPF 50+) daily to block harmful UVA rays.
Take oral antioxidant supplements, such as Heliocare 360 Capsules, to increase your skin's resistance to sun damage.

frequently asked
questions

Are treatments for Melasma available at all Skin Renewal clinics?

Treatments for Melasma are available in Gauteng at the Morningside, Parkhurst, Rosebank, Bedfordview, Fourways, West Rand, Irene, Waterfall, Irene, Lynnwood and Brooklyn clinics, as well as in the Western Cape at Cape Quarter, Claremont, Constantia, Century City, Stellenbosch, Paarl and Willowbridge clinics, and Kwa-Zulu Natal at the Ballito, Durban and Umhlanga clinics.

What does melasma look like?

Melasma typically appears as brown or greyish patches on areas of the face, such as the cheeks, forehead, upper lip, and chin. The pigmentation is usually symmetrical and can vary in size, often triggered by sun exposure or hormonal changes.

What vitamin deficiency causes melasma?

A vitamin deficiency does not directly cause melasma, but low levels of certain nutrients, like Vitamin D and B12, may exacerbate skin conditions. A well-balanced diet rich in antioxidants and essential vitamins can support overall skin health and may reduce the risk of pigmentation issues.

How do you stop melasma from spreading?

To prevent melasma from spreading, it's essential to wear a broad-spectrum sunscreen with SPF 50+ every day, avoid prolonged sun exposure, and use products containing ingredients like Vitamin C and tyrosinase inhibitors. Managing stress and maintaining hormonal balance can also help reduce the spread of melasma.

What foods cause melasma?

While there is no direct link between specific foods and melasma, diets high in processed sugars, dairy, and inflammatory foods can contribute to skin inflammation, potentially worsening pigmentation issues. A diet rich in antioxidants, such as fruits, vegetables, and foods high in omega-3, can promote healthy skin.

Does melasma go away?

Melasma can fade over time, especially if triggered by pregnancy or the use of birth control, but it often requires ongoing treatment and maintenance. It can persist or worsen without proper care, especially with continued sun exposure or hormonal imbalances.

What hormones cause melasma?

Hormones like oestrogen and progesterone are strongly linked to melasma. These hormones increase during pregnancy, when using oral contraceptives, or during hormone replacement therapy (HRT), which can trigger or worsen melasma.

Is melasma hard to treat?

Due to its chronic nature and deep pigmentation, melasma can be challenging to treat. To see noticeable improvements and prevent recurrence, a combination of professional treatments, consistent sunscreen use, and long-term skincare management is required.

Frequently asked questions