November 10, 2014

What's Wrong with My Face? My Struggle with Melasma

You know that woman who thinks it'd be awesome if she had a mustache?

No, you don't. Because that woman does not exist.

Now, thankfully I've never had a mustache but for about a year, my greatest fear would be that one day people would think I had one. Because for about a year, the skin above my lip was getting darker and darker, and I had no idea why.

To be clear, there was no hair above my lip; the skin itself was just getting darker. It wasn't extremely noticeable, but because I had no idea why it was happening, I also had no idea how to stop it from becoming extremely noticeable.

So like any millennial with an unexplained ailment, I went to Google with my symptoms. And for perhaps the first time in my life, Google didn't tell me I had cancer. Instead, Google told me that I was probably suffering from melasma.

What is melasma?

Melasma is skin discoloration, usually on the forehead, cheeks, jaw line, or upper lip, that results in brown, tan, or blue-gray facial skin.

My mouth with upper lip melasma
Who gets melasma?

Every website I've visited told me that over 90% of the people affected by melasma are women,
usually between the ages of 20-50. Melasma often begins during pregnancy. (Although, as an extremely not-pregnant woman, I can assure you that you don't have to have one cooking to have melasma.)

How do you get melasma?

According to Google and my doctors, no one is exactly sure. They think, however, that melasma is linked to hormones, particularly estrogen, and can be worsened by sun exposure. According to Dr. Brandith Irwin, hormones can affect the production of melanocytes (skin cells that produce melanin, the pigment that gives color to human skin, hair, and eyes). Apparently, sun can cause melanocytes to produce excess melanin, resulting in dark patches where dark patches should not be.

How do you treat melasma?

Unfortunately, there is no "Melasma-B-Gone" pill that works overnight. In fact, what works for some women seems to do nothing for others.

The first thing I tried was some OTC Hydroquinon skin cream (specifically, AMBI Fade Cream for normal skin). I used it for about six months and although the melasma didn't get worse, it also didn't get better.

After another few months, I went to my dermatologist, who prescribed me a stronger skin lightener. Unfortunately, my insurance didn't cover the cream so it would have costed me $100 out-of-pocket. Which would have been fine if I hadn't spent those extra Benjamins I had last month on, like, food.

I didn't want to spend that much money on face cream so instead, I went to my OB-GYN. He suggested switching me from the birth control pill I'd been taking for the past five years, Sprintec, to one with less estrogen. My insurance covered that, so I figured why not?

The first two months on the lower estrogen pill were rough. I can say that I wasn't paying much attention to the melasma at that point, but it was only because I was too preoccupied with the joys of hormone-induced acne. It was like I was bringing sixth grade back (which is something that never, ever needs to be brought back).

But after the third month on the lower-estrogen pill, my skin seemed to work itself out and the acne started going away. And with it, almost all of the melasma. Now, my skin is still slightly discolored but it is barely noticeable and definitely nowhere near what it was only a few months ago.


Now, I know that saying the acne and melasma are going away is most definitely going to upset the jinx gods out there, who will probably want to hand out a little karma to put me back in my place. But I know how embarrassing this problem can be so I am risking it so that this might help someone who is going through the same thing.

Like I said, if you also suffer from melasma, what's working for me might not necessarily work for you. But the bottom line is that you should talk to your doctors. You might have to kiss a few $100-creamed-frogs but eventually, you might just find an answer.