Ginger Zee Unmasks Her Experience with Melasma

Although GMA meteorologist Ginger Zee appears to have a flawless face, today she admitted that makeup hides a skin condition called melasma.

One year ago, Zee gave birth to her son Adrian. Although she adores her son, she admits that his birth has changed her life and body forever:

“I’m not talking about the still-pink scar that crosses my lower abdomen where I had a c-section. That and the deflated boobs are both parts of me that I have come to accept and love as a badge of honor for becoming a mother.

The day I looked in the mirror and saw a mask over my face, that was the day I said, enough is enough. My skin was brown in patches and bright white in others. It looked much different than it had before I had the baby.”

She went to dermatologist Dr. Whitney Bowe, who diagnosed her with melasma- a hyperpigmented rash on the face associated with hormonal changes. It is commonly found in pregnant women, and in women on birth control pills or estrogen replacement therapy.

What is Melasma?

Melasma is a common skin disorder, where patches on dark skin appear on sun exposed areas of the face, neck and forearms. The most commonly affected locations on the face are the cheeks, bridge of the nose, forehead, chin and over the upper lip. It can occur in women of any skin type, although women with darker skin tones are at higher risk.

Melasma is often associated with the female hormones estrogen and progesterone. Because of this it is often referred to as the “mask of pregnancy.”
But, besides pregnancy, it is also common in:

• Women taking birth control pills (Oral contraceptives)
• Women on hormone replacement therapy during menopause

Men can also get melasma, but they only represent about 10% of patients.

What causes melasma?

According the the American Academy of Dermatology, the cause of melasma is not yet clear. It is clear that the melanocytes in patients with melasma are producing too much pigment.

Cells called melanocytes are scattered among the cells in the deepest part of the epidermis. Melanocytes make the pigment (color) found in skin. When skin is exposed to UV radiation, melanocytes make more pigment, causing the skin to darken, or tan.

Common melasma triggers (what starts it) include:

• Sun exposure: Ultraviolet (UV) light from the sun stimulates the melanocytes. In fact, just a small amount of sun exposure can make melasma return after fading. Sun exposure is why melasma often is worse in summer. It also is the main reason why many people with melasma get it again and again.
• A change in hormones: Pregnant women often get melasma. When melasma appears in pregnant women, it is called chloasma, or the mask of pregnancy. Birth control pills and hormone replacement medicine also can trigger melasma.
• Cosmetics: Skin care products that irritate the skin may worsen melasma.

Melasma doesn’t cause any symptoms other than the rash, which is not described as painful or itchy. Many women however, dislike the way it makes their skin look.

How do dermatologists treat melasma?

The most common treatment for melasma is sun protection. Sun screen should be used everyday, and reapplied often. Wide-brimmed hats are also helpful.
Melasma can fade on its own. This often happens when a trigger is causing the melasma, such as a pregnancy or birth control pills. When the woman delivers the baby or stops taking the birth control pills, melasma can fade.

Some people, however, have melasma for years — or even a lifetime. If the melasma does not go away or a woman wants to keep taking birth control pills, melasma treatments are available. These include:

• Hydroquinone: This medicine is a common first treatment for melasma. It is applied to the skin and works by lightening the skin. You will find hydroquinone in medicine that comes as a cream, lotion, gel, or liquid. You can get some of these without a prescription. These products contain less hydroquinone than a product that your dermatologist can prescribe.
• Tretinoin and corticosteroids: To enhance skin lightening, your dermatologist may prescribe a second medicine. This medicine may be tretinoin or a corticosteroid. Sometimes a medicine contains 3 medicines (hydroquinone, tretinoin, and a corticosteroid) in 1 cream. This is often called a triple cream.
• Other topical (applied to the skin) medicines: Your dermatologist may prescribe azelaic acid or kojic acid to help lighten melasma.
• Procedures: If a topical medicine does not get rid of your melasma, a procedure may succeed. Procedures for melasma include a chemical peel (such as glycolic acid), microdermabrasion, and dermabrasion. A dermatologist should perform these procedures. New skin problems can occur when the person who gives the treatment does not tailor it to the patient’s skin type.

Tips for dealing with melasma

(From the American Academy of Dermatology.)

If you have melasma, dermatologists recommend the following tips for achieving a more even skin tone:

• Wear sunscreen daily: One of the most common treatments for melasma is sun protection. Since sunlight triggers melasma, it is important to wear sunscreen every day, even on cloudy days and after swimming or sweating. Choose a sunscreen that offers broad-spectrum protection, a Sun Protection Factor (SPF) of 30 or more, and zinc oxide and/or titanium dioxide to physically limit the effects of the sun’s rays on your skin. Apply sunscreen 15 minutes before going outside and reapply at least every two hours.
• Wear a wide-brimmed hat when you’re outside: As a recent study in the journal Nature illustrates, sunscreen alone may not give you the sun protection you need. Whenever possible, seek shade and wear protective clothing in addition to applying sunscreen.
• Choose gentle skin care products: Choose skin care products that don’t sting or burn, as products that irritate the skin may worsen melasma.
• Avoid waxing: Waxing may cause skin inflammation which can worsen melasma, so it’s important to avoid waxing areas of the body affected by the condition. Ask a dermatologist about other types of hair removal that may be right for you.