Dark spots were something I never had to worry about until I hit my mid-30s. When the first signs of melasma appeared above my upper lip, it was a shock. My sister, who is four years older, noticed the same darkening around the same time. We had both dodged the infamous “pregnancy mask” during our pregnancies, but now, as we approach pre-menopause, those dark patches seem to have made a delayed yet dramatic entrance. If you’re like me and have come to terms with these spots only to find them spreading, you’re likely wondering: what’s going on?
Why Are my Dark Spots Getting Worse?
Dark spots can worsen for several reasons, with sun exposure being a primary culprit. “Brown spots can occur on the face or body and have various causes depending on the diagnosis,” says Laguna Hills, CA dermatologist Jennifer Channual, MD. She explains that melasma, a type of hyperpigmentation, is particularly sensitive to sunlight. Even minimal sun exposure can trigger or exacerbate melasma, leading to the spread of dark spots.
Hormonal changes also play a significant role. “Hormones can act up in the summer, causing dark spots to flare up,” says Rochester, MI dermatologist Mariana D. Atanasovski, MD. This is especially relevant if you’ve recently started hormonal treatments like birth control. These hormonal shifts, including pregnancy or menopause, can increase melanin production, leading to new or worsening spots.
Why Are They Spreading?
The sudden spread of dark spots to another part of your face can be alarming, and it’s important to make sure that they are really multiplying and there isn’t another underlying concern says Austin, TX dermatologist David Bushore, MD. “You can’t treat it correctly without knowing the cause,” he warns. “Is it something innocuous like phytophotodermatitis, a rash due to contact with lime juice and sunlight, that will go away without treatment? Or is it something more serious like an infection, an autoimmune disease or even skin cancer?” This is why it’s crucial to see a board-certified dermatologist for a proper diagnosis.
“Brown spots can occur on the face or body and can have a variety of causes and triggers depending on the diagnosis,” says Dr. Chunnual. “If it’s melasma on the face, avoiding the triggers heat, sun and hormonal supplements can help. However, if you are experiencing hyperpigmentation in your skin folds, that may be hereditary, from friction or skin irritation or may be a sign of insulin resistance.”
If It Is Melasma….
“If this is melasma, any sun exposure will cause it to get worse,” notes Anchorage, AK dermatologist Janine Miller, MD. “Even five minutes in the sun will activate the melanocytes and cause hyperpigmentation.” However, staying out of the sun isn’t going to turn it around. To get a handle on dark spots, a multi-faceted approach that includes sun protection, lifestyle adjustments and targeted treatments are needed.
Sun Protection on the Daily
Effective sun protection is paramount for managing concerns like melasma and hyperpigmentation. Medical aesthetician Amy Peterson advises using sunscreens with SPF 30 or higher, particularly those containing physical blockers like zinc oxide and titanium dioxide. “Physical sunscreens are more effective for managing melasma, because they reflect UV rays and are less likely to irritate the skin,” she explains.
Peterson recommends the Alastin HydraTint Pro Mineral Broad Spectrum Sunscreen SPF 36 ($76) to her melasma patients. “This mineral sunscreen is a great summer option, because it has a light tint so you can wear it instead of foundation on hot summer days. It is also water resistant for the initial 40 minutes and provides long-lasting hydration.”
Dr. Channual says she prefers sunscreens with even higher SPF and additional ingredients like polypodium leucotomos, which can provide extra protection from sun exposure. “Oral supplements with polypodium leucotomos can also shield your skin from the sun,” she says.
Inner Glow Sol Defense Gummies ($30) harness the power of polypodium leucotomos and niacinamide to support sun protection and enhance your skin’s natural radiance.
Skin Care Is a Must
A consistent skin-care routine is also crucial for managing melasma, but it also needs to be the right one for you. Your practitioner should create a customized routine using products specifically formulated for treating pigmentation and melasma say our experts. For a targeted at-home treatment, Shreveport, LA dermatologist Skylar Souyoul, MD says she most often recommends a medical grade solution like the SkinCeuticals Discoloration Defense serum.
“This advanced serum is formulated with 1.8% tranexamic acid, 5% niacinamide and 5% HEPES, ingredients that work synergistically to reduce the appearance of dark spots and improve overall skin tone,” says Dr. Souyoul about SkinCeuticals Discoloration Defense ($110). “It’s suitable for all skin types and can be incorporated into your daily skin-care routine to address hyperpigmentation effectively.”
Expert-Approved Treatments
“If you’ve tried all the standard treatments and your melasma isn’t improving, you may have underlying prominent blood vessels contributing to increased heat on the skin’s surface,” says Dr. Bushore. “These blood vessels may need to be treated with a laser before melasma will start to improve. I’ve seen vascular laser treatments even prevent melasma from recurring in some patients.”
Dr. Bushore also highlights that an oral and topical combination approach may crack the code. “Prescriptions for hydroquinone-based creams and oral tranexamic acid are the mainstay of pigment reduction treatments,” he says. These treatments are highly effective in reducing melanin production and fading existing dark spots, making them essential in a comprehensive approach to managing melasma and hyperpigmentation
Keeping It Cool
To really get a handle on your spots, it’s important to stay cool and be mindful of your daily habits. “Avoid activities that trap heat in the skin and limit your time in the sun,” advises Peterson. “Long, steamy showers, hot yoga sessions and saunas can trigger melasma flare-ups. Even using hot hair tools can contribute to skin heat and worsen pigmentation.”
