Seeing Spots


Hey ya’ll!  Are you surviving Summer?  It’s getting to that hot part where the sun is scorching and the humidity is high.  If you follow me on Facebook or Instagram, you know that my family and I just spent a week on Hilton Head Island.  All my kids wanted to do was go to the pool and the beach, so I was applying sunscreen like it was my job.  As careful as i was, I still see some new brown spots on my cheeks.  Melasma.  well, shit.  I had this post from a few years ago.  I asked famed Dermatologist Dr. Elizabeth Rostan to give me the scoop on melasma and how to treat it.  Things may have changed, but this is still good info.  Check it out.


Me and the kiddos reppin’ the QC in HHI.  Hat from CltFind.  Bikini from Cupshe.  Adorable children from my uterus.




A common problem for women in general, pregnant or not, are the skin discolorations thats can pop up on your face at any age.  Some call it sun spots, sun damage, pregnancy mask, liver spots, or age spots.  This hyper-pigmentation can be a real pain to deal with, and good luck covering it up.  It can make your face look dirty, and can definitely make you look older.  Nobody needs that drama!  I’ve known tons of people over the years who’ve had this issue, so I went to my skin expert, Dr. Elizabeth Rostan to get the dirt on Melasma.

© ISM / Phototake


Amanda: What exactly is melasma?

Dr: Rostan:  

Melasma (muh-LAZ-muh) is a very common skin problem that causes brown to gray-brown patches on the face with sun exposure. It is most common in women but can also occur in men and affects the skin of the cheeks, nose, forehead, chin, and upper lip – typically in a distinctive pattern. It also can appear on other parts of the body that get lots of sun, such as the forearms and neck.

Amanda: What are some causes for melasma?

Dr: Rostan:  

The cause of melasma remains unknown but clearly hormonal factors and exposure to sunlight are critical to the development of melasma. Melasma can occur without hormone pills or pregnancy – only 25% of women report melasma occurring after starting an oral contraceptive pill. Thus melasma can occur with normal or endogenous levels of hormone. Melasma should be considered a chronic disorder that can persist for years.

It is still not known why certain areas of the face are predisposed to developing melasma while others are not involved. Hormone receptors, blood vessels, stem cell factors, and cutaneous nerves may play a role.

Amanda: Can it be prevented?  Do you recommend any specific product?

Dr: Rostan:  

I am not aware that melasma can be prevented but the very best prevention would be very careful and every single day sun protection as even a tiny bit of sun can trigger melasma.

Amanda: How do you treat it?  Topically, and procedurally?

Dr: Rostan:  

Treatment of melasma is very challenging and even with excellent results from a treatment, the pigment of melasma can and very often does recur. If melasma develops after starting a hormone pill, it is recommended that the pill be stopped and all similar hormonal pills be avoided in future; however, it is the experience of many melasma sufferers that the discoloration persists even after stopping all hormones.

I like to refer to this treatment pyramid which shows the steps of treatment – the first and most important is sun protection, then topical products and chemical peels and lastly laser treatments. The pyramid is an important symbol – laser treatment is often a last choice treatment and when a laser treatment is selected, the base treatments of the pyramid – sun protection and topical products – must be maintained.

Dr. Rostan:

I suffer from melasma myself and have treated it with everything on the above pyramid – with successes and recurrences. Even when my melasma is at a minimum, you can still see a bit of darkening in a pattern when you look closely – I call this the ghost of melasma. It is this “ghost” that haunts me and darkens again with sun exposure even with great sun block.
The good news is that all the things I recommend for treatment of melasma – most especially the careful sun avoidance – are all great anti-aging products and treatments. So that is the “sunny” side of this story – even though the dark patches are annoying, all that is done to treat and prevent them keeps your skin looking its best!

Amanda: Thanks so much, Dr. Rostan for all the great information on this annoying problem. It’s good to know there are options to manage and treat it. For more information, if you’re in the Charlotte area, contact Dr. Rostan’s office (Charlotte Skin & Laser) at 704.333.9113.


I’ll let ya’ll know what I end up doing about my own spots.  Enjoy your Summer, stay cool, wear a hat, slather on the sunscreen.  Until next post, there’s always Some Maintenance Required.




1 thought on “Seeing Spots”

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