Can Your Daily Routine Trigger Your Melasma?

Long showers followed by a multi hot-tool hair-styling process is my go-to routine for getting ready to see the world. I wish it was as easy as slapping on a tinted moisturizer, but let’s get real: putting on our faces sometimes means extended periods of time in a steamy bathroom with the door closed. I noticed recently that when I emerge, in addition to blown-out hair and a painted face, I walk away with darker patches on my face. It’s also happened when I’ve opened the oven to take out a pizza, after time spent in the sauna or even outdoors under an umbrella.

Since these dark patches first formed on my face (right above my lip thank you very much), I thought the only trigger was direct sunlight, so I’ve been vigilant with my SPF. It turns out, that’s not true, any time spent in heat can ramp up your melasma and hyperpigmentation. The experts say it’s not just an issue that involves sunlight, it’s also a vascular concern. 

Hot Showers, Saunas and Hot Tools

Spending time in high heat environments may be indirect triggers due to the vasculature component of hyperpigmentation, so it’s not far fetched to assume that spending long periods in the heat indoors can contribute to a melasma flare up which is commonly caused by hormones and sun exposure. “Recently, there have been studies showing that melasma is very much associated, not just with hyperpigmentation, but also an increase in vasculature,” explains New York dermatologist Orit Markowitz, MD. “In terms of treating it, we’re not just targeting the pigment, but now we’re also targeting the vessels. Just like with heat and irritation or other exposures, you do get dilatation or swelling of vessels, so the thought is that it is not going to be helpful for your dark patches.”

The Outdoor Heat

According to medical aesthetician Amy Peterson, your dark spots can ramp up even after protecting your skin with SPF, wearing a hat and sitting under an umbrella outdoors. Your skin doesn’t need to be exposed to induce a flare up. “I think sun exposure after the summer is a big culprit, but I think heat trapped in the skin while people are out and just doing activities is also to blame. It’s any time the skin is at a higher temperature, like when you walk in from the beach and see like all your freckles and any spots on your face. The heat will make everything appear more prominent.”

Blue Light Exposure

Staring at your phone or computer for too long can also contribute to the darkening of spots and patches. “There were studies done earlier in the pandemic and when everyone was sitting in front of their computers to measure if hyperpigmentation was exacerbated through blue light and what they found was that there was exacerbation from any sort of light exposure, not necessarily sunlight, although UV exposure is still the biggest culprit,” explains Dr. Markowitz. “We’ve also seen through studies that using iron oxides and various sunscreens showed improvement, even just from the blue light exposure.”

Keep Skin Cool

Above all else, you’ll want to keep the skin from heating up whether during your getting-ready routine or after any type of treatment. “You also want to keep skin cool to not trigger any further pigment or trap more heat, so using an ice roller like Kitsch‘s ($18) when you feel it heating up or after treatments is recommended. I advise my clients to keep one in the freezer and use it any time they feel their skin heating up, but especially after a treatment.”

The 15-Minute Solution

One at-home solution to help brighten dark spots is using a cream with an ingredient called cysteamine. “I have found cysteamine cream to be a great add on to skin-care routines to control hyperpigmentation,” says Aventura, FL dermatologist Bertha Baum, MD. Cysteamine works by inhibiting the overactive melanocytes that create more pigment in skin cells.

UrbanRx Hypercorrect Intense Fading Cream ($48) features 5% cysteamine and an independent study found that an independent study found that 87% of participants saw dark spots fade after 10 weeks of nightly use.

“It’s targeting the melanocytes which contribute to pigmentation, which is a little more unique than some of the older sort of bleaching or brightening creams that would only target exactly where they were placed,” says Dr. Markowitz. “Cysteamine is targeting the skin as a whole so so you don’t have to be very specific about where it’s applied. You use it on your entire face for under 15-20 minutes a day.”

Combination Treatments

Intense pulse light (IPL), chemical peels, laser treatments and microneedling with radio frequency can all help lighten spots by causing the skin cells to regenerate faster. Many of these treatments, like lasers and microneedling, help open up microchannels in the skin by causing microinjuries that signal skin to heal. “This is when we employ strong actives like mandelic acid or growth factors as those channels are open for a period of time afterward and the serums we use can be better absorbed,” says Peterson.

To treat this 43-year-old patient’s hyperpigmentation, Peterson performed two treatments of Palomar IPL and Clear + Brilliant Permea spaced two months apart, followed by four treatments of the Aerolase Neo and a Glytone Mandelic Peel spaced one month apart.

Clear + Brilliant Permea, Aerolase Elite and Tixel are all skin resurfacers that have been used, sometimes in combination, to help brighten skin and lessen pigment concerns. ““Tixel is a game-changer with delivering topical therapies. It gets as hot as a CO2 laser on the surface, but doesn’t actually damage deeper skin tissues,” explains Peterson. “This stimulates collagen production and repairs without causing more damage. Neo Aerolase goes deep and treats all kinds of contributing factors at a vascular level and breaking up deeper pigment. The combination of these two devices is incredible.” 

“PICO lasers are classically used to treat any sort of pigment whether it’s freckles or sunspots. But when treating melasma with heat and thermal energy, you have to be very careful not to apply too much heat or you can actually make it worse,” explains Dr. Markowitz. “We’re also seeing microneedling with radio frequency provide improvement in melasma.”

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