Although the term is very common, not all people know what it means melasma - and some are even startled by the name.

However, in view of the enormous reach of social networks, the topic has come up several times after some famous women revealed that they live with the problem, giving the subject more and more prominence.

Cleo Pires was one of them, when she confessed that she went through turbulent times, but that now she is treating the problem properly, as well as learning more about the disease and what it can cause.

Preta Gil, in turn, made a point of showing her face several times without any makeup or filter, highlighting the presence of melasma that already exists since her childhood and that is treated with constant visits to the dermatologist.

Read also: What happens to your skin when you are stressed

What is melasma

Melasma is a disease that leads to the appearance of spots Generally, these marks are more recurrent in women between 20 and 50 years of age and appear in places that are more exposed to the sun. sunlight as hands, face, arms, and lap.

According to a research by the Medical School of the Paulista State University (Unesp), it is estimated that this problem affects 15% to 35% of Brazilian women.

Read also: Causes, care and treatment for dark spots on black skin

"The fact is that when we expose ourselves to the sun without protection, our body ends up synthesizing more melanin The melanin generates the brown color in the skin, and when it is deposited on it, it ends up generating melasma spots", explains dermatologist Priscila Camara de Camargo, from Clínica Camargo, in São Paulo.

Types of melasma

Melasma can be classified into 6 different forms as to type and region, these being:

• Dermal: occurs when there is a deposit of melanin around deep and superficial vessels of the skin, that is, in the upper and middle dermis;
• Epidermal: when the pigment occurs in the most superficial layer of the skin, the epidermis;
• Mixed: the most recurrent type, it happens when melasma affects areas of the dermis and epidermis at the same time;
• Centrofacial - is the most common and can involve the malar, frontal, mentonian, supralabial, and nasal regions, all or some of them together;
• Malar - encompasses malar and nasal areas;
• Mandibular - affects only the mandibular region.

Main causes of melasma on the face

Melasma can arise due to a number of factors, varying for each individual.

According to the Brazilian Society of Dermatology - Regional of the State of São Paulo (SBD-RESP), the most common causes are:

• Genetics: there are still no researches that actually prove the relation of specific genes that could explain the appearance of melasma. However, the prevalence of the spots in certain biotypes suggests the connection. What is known, for the moment, is that brunette, black, and Asian women have a greater predisposition than very white women, such as European women.

• Sun exposure: hyperpigmentation occurs on the face when any other part of the body is exposed to the sun without protection, even if the face itself has been protected. Because of this, there is a production of the hormone that stimulates tanning, with receptors that end up reactivating melasma.

• Heat: according to experts, high temperatures dilate the vessels of the face, highlighting the melasma spots on predisposed skin.

• Hormonal changes: the use of contraceptives, fertilization treatments, and pregnancy are factors pointed out as triggering melasma, being the female hormone estrogen the main responsible.

Read also: 7 mistakes you make when sunbathing

Even so, faced with so many possible causes, dermatologist Priscila Camara de Camargo says that most cases are related to sun exposure.

"Therefore, it is important to use a filter with high SPF (always above 30)," she highlights, emphasizing that it is essential to maintain the follow-up with a dermatologist to identify the real cause of the melasma.

Does artificial light also cause these stains?

Those who think that only sunlight can trigger melasma are mistaken.

Artificial lights, such as lamps, luminaries and computer, cell phone, tablet and television screens are sources of radiation that can also influence the worsening of facial stains .

This information has been proven by studies that have pointed out that this type of light also has a direct effect on the production of free radicals - although to a lesser extent than sunlight - by damaging the cells of the face, including melanocytes, i.e. the cells specialized in melanin production.

Read also: Blue light from cell phones can damage the skin. Learn how to reverse it

For this reason, the use of sun filter also indoors, so that it protects the skin from artificial light.

Not all products, however, are able to offer this protective action. In this case, it is necessary to use a filter with titanium dioxide or zinc oxide.

Is Melasma curable?

Melasma is a chronic skin condition and relapsing - that is, occurring recurrently or repeatedly - that has no cure.

It is worth pointing out that, because it is a predominantly cosmetic disease, it does not offer any associated health risks.

Even so, the ideal is that its appearance be controlled with some care, since the spots appear and disappear from the skin recurrently.

Read also: Reasons to use sunscreen in the home office

Prevention of melasma

According to Priscila, it is possible to adopt some measures to prevent the appearance of skin patches .

The first and most important of these is to use sunscreen daily, because, besides preventing melasma, it also reduces the worsening of existing conditions and protects the dermis from the risk of skin cancer. skin cancer .

If you are predisposed to melasma, it is also wise to talk to a doctor before starting hormone replacement treatment or with birth control pills as these drugs can lead to a worsening of the facial marks.

Read also: Learn about the side effects of stopping contraception

Treatment for melasma

Once the spots have appeared on the skin and have no cure, the best option is to bet on a treatment for melasma, either through products or procedures.

A widely used technique is the application of depigmenting substances on the skin. As the name implies, the product acts to reduce the pigmentation of the region, minimizing the spots on the face. acids This can even increase the effectiveness of the treatment.

Devices that generate exfoliation superficial on the face, such as microdermabrasion (crystal or diamond peeling) and ultrasonic peeling, for example, can also collaborate to the permeation of acids and whitening substances, assisting in the removal of pigment from the upper layers of the skin.

Read also: Benefits of different acids for the skin

Another well-known procedure is needling It can be done either with a micro-needling roller or with a dermograph.

In this case, the micro-needles cause small lesions in the skin to activate the phagocytes - in other words, the body's cleaning cells - which will clean the region and remove the melanin along with it. As a result, at the end of this process, the skin will be ready for a deeper permeation of the treatment products.

Finally, the laser can also contribute to alleviate melasma, since it promotes an energy shock to the pigment in a short time interval, causing an "impact" that breaks the pigment's structure. With this, the melanin will be phagocyted and totally absorbed by the cells.

It is worth remembering that vitamin C is also a great substance to ease melasma, since it is antioxidant and inhibits the action of tyrosinase - an enzyme considered key in skin coloring and that plays an important role in the biosynthesis of melanin.

But don't forget that each body works in a different way and, therefore, it is necessary that each case be evaluated individually in order to carry out a treatment according to the patient's needs and restrictions.

Food for melasma

As with countless other diagnoses, diet has a huge influence on the intensity with which melasma appears on the skin.

According to dermatologist Juliana Toma, from São Paulo, knowing which foods should be avoided and which deserve priority can help prevent or attenuate the spots on the face.

Foods that worsen melasma

The main villains of melasma are those foods that contribute to the increased production of estrogen hormone However, other nutrients can also harm this picture.

See below the list indicated by Juliana:

• Sugar

Besides offering countless health risks, sugar is one of the foods that contributes the most to the increase in the glycemic index, being the main catalyst of inflammatory processes and, consequently, intensifying the spots.

• Processed Foods

Snacks, sausage, nuggets, fast food, and frozen foods are also foods that promote inflammatory processes and cause a series of chemical reactions that produce substances that create an inflammatory environment in the body.

• Multigrain Bread

Despite being touted as a healthy food in many diets, some versions of multigrain bread have ingredients that can contribute to browning, such as wheat and flaxseed.

This is because both are rich in estrogen, which, as explained before, can worsen melasma.

It is worth pointing out, however, that with regard to blemishes, it is not necessary to take these items out of the diet, but rather to reduce their consumption.

• Refined carbohydrates and gluten

These substances commonly found in pizza, bread, snacks, and other types of dough are high in sugar, intensify oil production in the skin, and deplete the body's good bacteria.

• Dairy products

Milk derivatives are also naturally pro-inflammatory. In addition, they can contain synthetic hormones, which, by not being digested properly, can contribute to the inflammation of the spots. The ideal, in this case, is to avoid excessive consumption.

Read also: The best and worst foods for people with vitiligo

• Soy milk

Alternative for milks of animal origin The tip is to replace it with oat milk or almond milk.

• Tofu

Like soy milk, tofu is a healthy ingredient, but it also has negative effects for melasma, since it has a high concentration of phytoestrogen, which mimics the action of natural estrogen, causing imbalances that worsen melasma.

• Alcoholic Beverages

Besides causing dehydration, drinks such as beer are rich in wheat and sugars, and also compromise the liver. As a result, they release toxins into the skin, causing inflammatory and pigmentation processes, such as melasma.

• Coffee and foods rich in caffeine

It is the same case as with alcoholic beverages, in that it affects the liver, but with the added aggravating factor: caffeine increases the production of the stress hormone cortisol, which can worsen skin conditions.

• Pea

Excessive consumption of peas can worsen melasma, since they are rich in estrogen and starchy, which is responsible for their higher calorie content compared to other vegetables.

Foods that improve melasma

According to Juliana, foods with photoprotection, antioxidant, and anti-inflammatory characteristics are the allies of people who suffer with spots.

"The intake of foods rich in folate, flavonoids, vitamins A,C,E (antioxidants), resveratrol, beta carotene, lycopene, lutein, and selenium is recommended," points out the dermatologist.

Among the foods with a high concentration of these nutrients are:

• Foods with intense colors (orange, red, purple, green), such as carrots, sweet potatoes, onions, artichokes, purple cabbage, broccoli, beets, etc;
• Red fruits (blackberry, raspberry, strawberry, etc);
• Leafy greens and herbs (kale, chard, spinach, cilantro, basil, thyme, etc.);
• Green fruits (Kiwi and avocado);
• Spices (turmeric, cinnamon, clove, saffron, ginger, etc);
• Oilseeds (walnuts, almonds, chestnuts, hazelnuts, etc.)
• Green tea and matcha.

Finally, it is important to maintain good hydration of the body by consuming plenty of water throughout the day.

"It is also worth pointing out that the improvement in diet not only helps in the prevention and whitening of melasma, but also in the general health of the skin. A good diet reduces spots, redness, improves tone, texture, among other signs of aging," concludes the professional.

Melasma in pregnancy

The melasma that appears during pregnancy has a different name from the others: chloasma. Its characteristics, however, are no different from the normal version of the chronic problem, since it consists in the appearance of spots, especially after the absence of sun protection.

It is important to clarify that only during the gestation period this condition is called cloasma After the birth, if the spots persist, the diagnosis becomes melasma.

Read also: 9 changes in body and mind during pregnancy

Moreover, in some cases where the pregnant woman does not expose herself to the sun, the marks can spontaneously disappear after pregnancy.

To prevent this problem, the indication is the same as for non-pregnant women: constantly use sunscreen, besides moisturizing the skin well and reducing sun exposure, especially at times when the sun is strongest.

Another option is, if there is medical guidance, to use dermocosmetics with vitamin C in their composition, after the beginning of the third trimester of pregnancy.

Which professionals to look for

If you have noticed the appearance of melasma on your face, the ideal is to see a dermatologist to evaluate what these marks are and what the causes were.

Besides caring for skin blemishes, the dermatologist specializes in the diagnosis, treatment, and prevention of diseases of the skin, mucous membranes, hair, nails, and hair.

What to ask the doctor in the consultation

When making an appointment with the professional, it is ideal that you already have in mind what questions to ask, to clarify any issues involved with your case.

Some important questions are:

• What type of melasma do I have? After a complete evaluation in the office, the professional will be able to point out what type of stains you have.
• Why did the stains appear? By knowing a little more about your routine and your lifestyle, the doctor can indicate which factors led to the appearance of the marks on your face.
• What treatment should I do? After the diagnosis, the dermatologist will know how to conduct your treatment, be it with home care, in-office procedures, or a combination of both.
• What to do on a daily basis to reduce melasma? Adding some simple cares to your routine can contribute to make your facial marks lighter, besides avoiding their darkening. Take note of the professional's tips!
• Can people with melasma sunbathe? For being one of the factors that stimulate the appearance of spots, the ideal is that sun exposure is moderate, and always with the use of sunscreen and physical blockers such as a hat or cap.
• Does melasma only appear on the face? Although it is more recurrent on the face, the spots can also occur, rarely, on other places such as neck, neck and arms. This is the so-called extra-facial melasma.

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Sources :

Priscila Camara de Camargo, dermatologist at Clínica Camargo, in São Paulo;

Igor Lustosa, dermatofunctional physiotherapist from São Luis, Maranhão.

Juliana Toma, dermatologist in São Paulo.

Useful Links

Brazilian Society of Dermatology

SBD - São Paulo Regional Office

SBD - Rio de Janeiro Region