Understanding Hormonal Influences on Melasma and How to Treat It

If you have developed brown or grayish patches of skin on your face, you may suffer from melasma. Genes, ultraviolet (UV) rays, pregnancy, hormones, thyroid disease, anti-seizure medications, and medications that react to UV rays are all potential causes. But hormones seem to play a role, even when they aren’t the primary cause.

Your endocrine system comprises glands located throughout your body. Those glands produce a wide range of hormones — chemical messengers that regulate numerous bodily functions. This includes the function of your organs, and your skin is the largest among them.

Melanin is what determines the color or pigmentation of your eyes, hair, and skin. Produced by cells called “melanocytes,” its job is to absorb harmful UV rays to protect your skin cells. But when melanocytes are overproduced, the result is hyperpigmentation, including melasma.

If you suffer from melasma, it’s important that you understand how hormones influence its development. If you do, you’ll understand how certain treatments combat it. Here is where you might want to begin.

Treatments Target Sources or Symptoms

The dark patches and spots symptomatic of melasma are cosmetic. In other words, they impact your appearance but don’t pose a serious health risk. That said, melasma can cause anxiety, depression, or other emotional issues to sufferers, so treating it can be very important.

Limiting exposure to UV rays is a must-do, even in cases when hormones are driving the formation of dark spots. The sun induces melanin production, which may result in a great tan but may result in melasma. It’s important that you protect yourself from UV rays.

Effective melasma treatment options include hydroquinone, tretinoin, and azelaic acid. Although there are over-the-counter products that target dark spots, these prescription medications pack a more powerful punch. But they all come at melasma from a different angle.

Hydroquinone halts production of melanocytes over time by damaging them at the cellular level. Tretinoin is a retinoid that increases collagen production and accelerates skin renewal, reducing the time melanocytes have to do their damage. Azelaic acid inhibits the melanin-producing enzyme tyrosinase, effectively blocking the cells that produce pigment.

Now that you know a little about key melasma treatments, you should learn more about why they work. Since you can’t prevent melasma from happening, it’s important to understand why certain treatments work to diminish those dark spots.

Pregnancy and Birth Control Are Culprits

If both pregnancy and birth control can cause melasma, it may seem that women can’t win for losing. The fact is that a woman’s reproductive system is driven by hormones. Whether you’re pregnant or trying to keep from getting that way, it’s a hormonal matter.

It’s common for melasma to rear its ugly head during the third trimester, which is why it’s called “the mask of pregnancy.” The exact cause is unknown. But estrogen and progesterone, which are both hormones that stimulate melanocytes, are in high gear at this time. A whopping 50-70% of pregnant women will develop melasma. It may fade postpartum but may not go away completely.

Avoiding sun exposure may help, but azelaic acid may be the best solution for lightening dark spots. In fact, it may be the only viable solution since neither hydroquinone or tretinoin is recommended for pregnant women. Many doctors will not prescribe it to breastfeeding mothers either.

At the other end of the reproductive spectrum is hormonal birth control containing synthetic versions of estrogen, progesterone, or both. This birth control comes in different forms, including pills, patches, injections, and intrauterine devices (IUDs). They alter the body’s natural balance of estrogen and progesterone. Tinkering with that balance may increase melanocyte production and cause melasma.

Hormonal birth control is highly effective in preventing pregnancy. Although melasma may be a side effect, it’s easier to deal with than conceiving when you don’t want to. A prescription for effective melasma treatment may be the far better option.

Hormones Always Play a Role

Pregnancy and birth control are obviously related to hormone-induced melasma. But other likely causes aren’t without a hormonal component. In addition to UV exposure, thyroid disease shares a relationship with melasma.

The thyroid plays a key role in the endocrine system. It produces hormones that regulate metabolism, which is how your body converts food into energy. Overproduction of thyroid hormones is hyperthyroidism. Underproduction is hypothyroidism.

So, how does the production of hormones in the thyroid affect melasma? There is a documented relationship between hyperthyroidism, in particular, and melasma. It’s so much so that researchers recommend that patients with melasma be tested for thyroid disease as well. Treating the thyroid condition may reduce hyperpigmentation.

In addition, the pituitary gland discharges hormones that stimulate production of melanocytes. Exposure to UV light increases the production of those hormones which, in turn, increase production of melanocytes. And since overproduction of melanocytes causes hyperpigmentation, there’s a direct relationship between UV exposure and hormones.

It makes sense that avoiding exposure to UV radiation and treating thyroid disease should decrease melasma symptoms. Those are two ways you can keep your hormones — and melanocyte production — in better balance.

Shine a Light on Dark Spots

Everyone wants clear, unblemished skin. If melasma is scattering dark spots and patches on yours, you need to shine a light on them. (Of course, don’t shine sunlight on them.)

But do work with a healthcare provider who understands melasma and can prescribe treatments for it. There are solutions that will reduce or eliminate unsightly spots. All you need to do is find the right one that works for you.

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