Why is my melasma and hyperpigmentation so much worse suddenly?

Hello Dr. Irwin, I just discovered your blog after realizing that my melasma (which I sort of accepted and had gotten used to) seems to be spreading from my cheeks to now even lower on my face. It is both scaring and depressing me quite a bit because it will mean ever more makeup and coverage to use. For the last 2-3 years, my melasma has been isolated to the cheeks and forehead and although summer is the worst for coverage (my makeup just sweats off), I have lived pretty much ok with it with the right makeup procedures. But I really, really didn’t think that it would spread anymore.

– J

This is that time of year when I like to do a post on melasma and hyperpigmentation because for almost everyone with an uneven pigment problem, it’s getting worse at the moment.

Many of you may be noticing that:

  • Whenever you go outside or drive the blotchy pigment looks worse.
  • That it doesn’t fade as quickly once it looks darker.
  • That heat seems to make it worse also.

The brown areas whether they are melasma or not, all get worse around the summer solstice, which is June 21. The UV light, especially UVA, is at it’s strongest point of the year. UVA activates pigment, is hard to block with sunscreens and goes through windows, including car windows.

What you can do to limit the spread of the uneven pigment:

  1. Double or triple sunscreen for the next 2-3 months.  Use a 12-20% zinc oxide sunscreen every morning. Then put a make-up with sunscreen or a tinted sunscreen over that. You can put a layer of mineral powder make-up with an SPF over that or a powder sunscreen like the Colorescience SPF 50.
  2. Remember you don’t care about the SPF as long as it’s over SPF 30 because SPF only refers to UVB and it’s UVA that is most of the problem right now. Look for mineral sunscreens with zinc or titanium totaling over 15-20%. The most common second mineral in sunscreens is usually titanium.
  3. Reapply several times during the day if you are sweating or outside a lot.
  4. Wear a wide brimmed hat – the wider the better.
  5. Don’t get any laser treatments this time of year. Thermage or any sound wave based treatments are usually fine, but discuss with your doctor.
  6. Consistency is the key for this problem.
  7. Get off any estrogen containing medications if you can, but discuss with your primary care doctor first. Be sure to tell them you have melasma.
  8. Use an antioxidant like the C+E+Ferulic under your sunscreen and reduce your retinol or hydroxy acid use for a month or two.
  9. If it’s moderate or severe, please see your dermatologist for a prescription like Triluma.

Hope this helps,

Brandith Irwin, MD

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