A survey by the Unesp Faculty of Medicine estimated that 15% to 35% of Brazilian women suffer from melasma. Well, those dark spots on the skin are a more common problem than you might think. Melasma mainly affects women: hormonal changes, especially during pregnancy and menopause, and the use of oral contraceptives are risk factors. Discover in this article what types of melasma are and what to do to improve the spots on your face.

What is melasma?

It is a dermatological condition characterized by the appearance of dark and discolored spots on the skin, mainly on the face, in addition to also affecting areas exposed to the sun, such as arms and chest. These spots can vary in size and shape and are caused by increased production of melanin, the pigment that gives color to the skin. Although the causes of melasma are not completely understood, factors such as excessive sun exposure, genetic predisposition and hormones, related to pregnancy or the use of contraceptives, play an important role in its development.

Diagnosis and assessment

Diagnosing and evaluating melasma involves a careful process of identifying symptoms, seeking guidance from a dermatologist, and assessing the severity of the condition.

Identification of symptoms

The first step in identifying melasma is recognizing the symptoms. The appearance of dark, discolored patches on the skin, especially on the face, forehead, cheekbones and above the upper lip is the main one. These spots tend to be more visible after sun exposure and can vary in size, shape and intensity of pigmentation.

Consultation with a dermatologist

Once the symptoms or suspicions of melasma have been identified, the next step is to seek guidance from a dermatologist. During the consultation, the doctor must perform a thorough analysis of the spots, ask about the patient's medical history and examine risk factors, such as sun exposure and use of hormonal medications. It is important to provide detailed information to your healthcare professional to help make an accurate diagnosis.

Assessment of melasma severity

After diagnosis, the dermatologist will assess the severity of the melasma. There are different degrees, ranging from superficial, light spots to darker, deeper spots on the skin. The professional must also identify the type of melasma:

• Epidermal melasma : most common type of melasma, occurs when excess melanin is concentrated in the most superficial layer of the skin, known as the epidermis. The spots are dark and well defined.
• Dermal melasma : excess pigmentation occurs in the deeper layers of the skin, in the dermis. The spots are brownish, may be more diffuse and less defined than in epidermal melasma. Dermal melasma is often more resistant to treatment.
• Mixed melasma : in this case, both the epidermis and the dermis have excess pigmentation, resulting in spots that vary in intensity and appearance. Mixed melasma can be particularly challenging to treat.

Prevention and general care

Prevention and daily skin care play a key role in managing melasma, helping to prevent dark spots from worsening and minimizing their recurrence. See the main measures to put into practice here in the article.

Use of broad spectrum sunscreen

One of the main factors that trigger melasma is sun exposure. Therefore, regular use of broad-spectrum sunscreen is essential for prevention. This type of sunscreen offers protection against UVA and UVB rays. It should be applied daily, even on cloudy days, and reapplied every two hours, especially during sun exposure on the beach or in the park.

Avoid direct sun exposure

One of the most effective measures to prevent melasma is to avoid direct sun exposure, especially during hours of peak ultraviolet ray intensity, which generally occur from 10 am to 4 pm. On days when direct exposure cannot be avoided, it is recommended to wear long-sleeved clothing, wide-brimmed hats and sunglasses to protect your facial skin.

Avoid habits that exacerbate melasma (smoking, excessive alcohol consumption)

Some habits can make melasma worse. Smoking, for example, contributes to premature skin aging and is capable of increasing irregular pigmentation. Excessive alcohol consumption can also worsen melasma, as it dilates the blood vessels in the skin, making the spots more visible.

Skin with melasma or prone to this dermatological condition is more sensitive, so it is recommended to avoid using irritating or toxic products – they are risk factors for the appearance of spots.