A Self Help Approach to Melasma

Melasma (also called Chloasma) is the name given to a patchy darkening of the skin on the face. This occurs particularly in some groups of north Asian women. It often first appears during pregnancy. Sometimes it fades on its own but sometimes it is stubbornly persistent. Or it goes away, just to return with the menopause. The following research, notes and ideas have been put together in one place to share a resource of self-help approaches. This is not a medical approach but a resource to help understand melasma and offer natural approaches to try to reduce the appearance of melasma which many women find so very distressing. My deepest thanks to all the women of the Nepalese community in Edinburgh for sharing their selves and their stories.

WHAT MAKES MELASMA HAPPEN?

1.     Hormones: Changes in hormone balance (especially oestrogen) can trigger melasma. For example

• Pregnancy (especially if low intake of Folic Acid)
• Contraceptive pill / contraceptive injections
• Menopause / HRT
• Ovarian disorder

2.     Sunlight: Both Ultraviolet A (UVA) and Ultraviolet B (UVB) rays from the sun are believed to contribute to the formation of melasma in predisposed persons.

3.     Phototoxic reaction: Exposing your skin to sunlight after applying some chemicals found in creams, soap or perfume can cause it.

4.     Medications: Melasma may also be triggered by some medications such as Dilantin (phenytoin) and the contraceptive pill.

5.     Copper: There has been a lot of discussion recently about the contribution of copper to melasma. Copper is often found in fungicide crop sprays and the residue is left on fruits and vegetables. It is also sometimes an ingredient in some contraceptive pills. A high copper low zinc diet can affect melasma, oestrogen levels and yeast imbalances.

6.     Hereditary: Unknown factors perhaps hereditary. This means that if your mother had it, then you are more likely to have it too.

THINGS THAT MAY HELP

1.     Sun Protection

Avoiding the sun and using sunscreen are key to preventing melasma. Always wear face cream with SPF sunscreen in it, at least SPF15 but SPF30 is better. Use hats, sunglasses, visors, and window shades, as UVB rays are just as intense through the window or on cloudy days. Just because you can’t see the sun, does not mean it isn’t having an effect. However, it is still important to go outside (with protection on) because the action of the sun on your skin helps in the creation of Vitamin D in the body – a valuable skin vitamin.

2.     Careful Chemical Choices

All skin products, except those you make at home, have chemicals in them.Some of these chemicals can make melasma worse. Do not use strong soaps and abrasive facial cleaners and products that will irritate the facial skin. Only use a mild soap or gentle cleanser for washing. Be very aware of what is in the products that you put on your face. Skin lightening creams in particular can make your melasma worse not better!

3.     Hormonal Balance

Contraception: For some women, their melasma is sensitive to hormonal change. If you are taking the contraceptive pill, injection or implant, you might notice a relationship between when you started taking it and your melasma. Hormonal balance can make melasma worse or better. Copper is also in a lot of pills – read the small print in the leaflet. If nothing else helps, you might want to change the type of contraception you use. You might try a period of using a non-hormonal type of contraception such as a coil, cap (diaphragm) together with a condom to allow your body to return to its natural state. Be careful to discuss this approach with your husband so you have his co-operation and be careful not to get pregnant (unless you want to).

Pregnancy: If you are pregnant or planning to become pregnant you are entering a time of huge hormonal change. Taking a good quality prenatal vitamin supplement with Folic Acid can help to protect you.

Imbalance: If your hormones are unbalanced you might notice this through irregular periods, or you might be going through the menopause. Visiting a medical herbalist can help you to balance yourself naturally as may plants, such as Red Clover, contain phytoestrogens which mimic the body’s own hormones.

4.     Fantastic Food

Diet: There are certain essential nutrients that your body needs to be healthy. To support your skin naturally when you have melasma eat more foods high in folic acid such as

a.     dark green leafy vegetables like spinach
b.     wheat germ
c.     asparagus
d.     broccoli
e.     potatoes
f.      whole grains, fruits and vegetables

Your skin also needs a good, well balanced diet to be clear and attractive. If you drink lots of water (2 litres per day) and eat a light diet of fish, white meat, vegetables, salads, wholegrains and fruits, you will help your skin. Diets with lots of sugar, sweet things, fizzy drinks, fatty things, bread, cakes and carbohydrates make your stomach feel full, but clog your digestive system and do not give your body the Vitamins and Minerals it needs to be healthy.

To avoid accidental intake of copper, wash everything very well or try to buy or grow organic fruit and vegetables. Also avoid foods that contain a lot of copper: coffee, avocados, almonds, soft drinks.

Probiotics with a wide variety of beneficial bacteria help to restore any yeast imbalances. If you have had had persistent candida or thrush, foot fungus etc you may have a yeast imbalance too.

5.      Give up Smoking

No excuses. Today! Apart from all the known, massive health risks, cigarettes contribute to a build up of copper. The smoke is very bad for the facial skin and smoking will make your skin look old before your time!

6.     A Natural Approach

Keep a Daily Diary: Get a notebook. For three months every day, write down a note of everything you eat or drink, put on your skin, where you are in your period cycle, any medication you take. Grade your melasma on a scale of 1-5. Make 1 very bad, 2 bad, 3 usual state, 4 better, 5 much better. A diary will help you to understand the patterns and triggers of what makes it better or worse. If you decide eventually to see a specialist such as a Medical Herbalist, this diary will be extremely useful to help to treat you.

Supplements: As well as eating a good diet and drinking plenty of water, take a Vitamin and Mineral Supplement to make sure you body gets everything it needs. Cheap vitamins are not always as good as more expensive vitamins but still cost less that a new outfit!! Make sure a Multivitamin Formula includes Vitamin A, B group, C, D, E, Calcium, Chromium, Iron, Magnesium, Selenium, Zinc and Folic Acid. (To avoid supplements that contain Copper you might find that a Prenatal Supplement is best.)

Essential Fatty Acids: To ensure you get all the fatty acids your skin needs you should also take either Omega 3 Fish Oil Capsules or a vegetarian Evening Primrose Oil Capsules or Hemp Seed Oil Capsules as a food supplement. Good quality brands include Viridian, Solgar and Higher Nature. Cheap supermarket vitamins are not always as helpful. Do not take large doses of single vitamins without going to a healthcare practitioner.

Pycnogenol: Some melasma sufferers have found that Pycnogenol (Pine Bark extract Pinus maritima) helps. A clinical study has also been published that found a significant difference in 30 women over 30 days. You can buy Viridian Pycnogenol 26mg with Grape Seed Extract 24mg capsules and take one three times a day with meals for 30 days. They cost around £15 for 30 capsules (10 days supply) and £26 for 60 capsules (20 days supply). (Remember to record everything in your Daily Diary so you can assess whether this works for you.)

Skincare: Use very simple, unfragranced products like pure Cocoa Butter to moisturise your skin during the day. (Remember that sunscreen!) Rose Hip Oil is also very good for the skin and a very light oil. At night use Napiers Age Defiance Cream as a night cream (but do not use it if you are going out in the sun). Age Defiance cream is traditionally used as a hand cream to reduce the appearance of age spots, sun damage and freckles.

Do not use soap and cleansers on your face. Just splash with water. Instead clean your skin with a very gentle home-made exfoliator just once or twice a week. Get a handful of oatmeal, add a little honey and a splash of vegetable oil, mix together and use this as a facial scrub. Massage gently into your skin. Leave on for 5 minutes. Rinse off with cold water. This will also leave your skin feeling incredibly soft.

And lastly,

Remember that you are beautiful. In the past, the present and the future.

Beauty is internal and shines through the eyes from your soul. No matter what scars and marks our bodies bear, it is this fundamental truth that makes you beautiful in the eyes of those who love you.

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Monica Wilde MSc is a Research Herbalist at Napiers the Herbalists, established in 1860. Napiers supplies vitamins, minerals and specialist herbal, natural skincare.

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