Dark circles that won’t fade, no matter how much sleep you get. 

Shadow-y leftovers from last year’s tan. 

A sprinkling of smudged freckles that weren’t there before your pregnancy. 

When dark splotches suddenly appear on your forehead, chin, under the eyes, upper lip, cheeks, or nose, it can become a cause for concern.

In many cases, the cause is melasma, a condition characterized by hyperpigmentation on the face.

What is Melasma?

Doctors and dermatologists aren’t quite sure what causes melasma, but some risk factors seem to correlate with the condition. 

For example, it’s often called the “mask of pregnancy” because of its prevalence in expectant mothers. The sudden increase in estrogen and progesterone, both of which flood the body during pregnancy, is associated with melasma. That also puts those on hormonal birth control or  hormone replacement at risk with up to 50% experiencing skin darkening.

We already know that sun exposure can cause skin darkening, but sometimes a summer tan lasts well past its prime. UVA and UVB rays stimulate melanocytes, the pigment-producing cells in our skin. Melasma flare-ups are more common in those who are not diligent about applying SPF.  While these patches are not physically harmful, they can make patients feel self-conscious.

Treating Melasma with Prescription-Strength Hydroquinone and Tretinoin

While some cases of melasma fade on their own, other times it can be pretty persistent. For those situations, prescription-strength hydroquinone and tretinoin might be the answer.

Hydroquinone has long been revered as a holy grail treatment to brighten the skin, heal darkened scar tissue, and treat skin discoloration. It’s available over the counter in limited concentrations but available at higher strengths with a prescription. It works by physically lightening darkened patches of skin, reducing melanin production, and eventually fading hyperpigmentation back to normal. 

Tretinoin, a synthetic retinoid derived from vitamin A, works much like retinol but at a much stronger level. That’s why it’s only available as a prescription. It deeply exfoliates the skin, stimulates collagen and elastin production, and speeds up cell turnover. The dark melasma spots gradually fade as your body sloughs hyperpigmented cells and replaces them with new, unaffected ones.  

Together, prescription-strength hydroquinone and tretinoin are a knockout combination in the treatment of melasma. Hydroquinone gets to work, lightening overactive melanocytes while tretinoin exfoliates away the affected skin, encouraging new cell growth in its place. 

These two skin treatments are available this fall at AST. Stop by for a checkup with our board-certified provider, Dr. Elizabeth Briden, who can tell you more about melasma and your treatment options. If hydroquinone and tretinoin are right for you, save time by picking up your prescription in-house at one of our locations across Minnesota.