Melasma (Facial Pigmentation)
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Melasma pigmentation generally only affects the face and neck, where the skin is exposed to the sun. Sunlight is terribly reactive. Melasma (aka chloasma) patients are about 94% female, and only about 6% male. This tells you a lot right there, since women are far more hormonally affected than men. This is an international issue, and affects people of all races. Dark facial pigmentation often affects 50 to 70% of pregnant women in some countries. Fortunately, this usually disappears after they give birth. This tells you even more, since hormones change dramatically during, and after, pregnancy. For many women, however, the dark spots are permanent and psychologically debilitating. Self esteem and confidence are strongly affected. This is basically due to hormone imbalance. The cure is diet, lifestyle, and natural hormone balance. The real answer is internal, not topical. Read the article Balance Your Hormones. Read my book Natural Health for Women.
The most important thing to understand is the cure is internal, not external. You are never going to cure this with Magic Creams or Magic Lotions. The real cure is diet, lifestyle, and hormone balance. Holistic whole body health always treats the cause, and not the symptom. Think whole body health, and not “skin disease”. Read the article Seven Steps to Natural Health:
*Diet is everything. Diet cures disease; an American macrobiotic whole grain diet.
*Hormone balance is the basic issue with skin pigmentation disorders.
*Proven supplements strengthen the entire body. Read Serious Supplement Program.
*All Rx drugs must be stopped with rare exceptions (e.g. temporary antibiotics).
*Bad habits like alcohol and caffeine must be ended to be healthy.
*Weekly fasting is a powerful tool to get and stay well.
*Everyone needs to exercise regularly.
This article also refers to vitiligo. Also read the Skin Conditions article.
Nearly always, these poor, desperate women run to the doctor, and throw money at them for Magic Creams and Magic Drugs. These attack the symptom, and ignore the cause. None of these work, and nearly all of them have serious side effects. Doctors can do nothing for you here. Think whole body health and not "skin". Low level laser therapy with a 940 nm low watt laser was effective however (J. Clin Aesthet. Dermatol vol 11, 2018). Two other studies successfully used 1,064 nm 675 nm lasers to get good effects.
The problem here is that laser therapy is expensive, and you must find a doctor with the proper dermatological laser. Yes, this can probably help you, but it is not a cure.
Melasma has been clearly associated with birth control pills, pregnancy, HRT (using Premarin®), and toxic oral progestins such as Provera® and Megace® (which are not real progesterone at all). Real, natural progesterone should be used transdermally. The medical insanity includes hydroquinone, Retin-A®, tramexamic acid, azelaic acid, kojic acid, magnesium, mulberry, zinc, fluocinolone, ellagic acid, arbutin, and vitamin C creams. Also oral tramexanic acid. These only make you worse in the end, and ruin your skin.
During pregnancy, estradiol, estrone, estriol and progesterone levels rise dramatically. Estriol and progesterone are not the cause of melasma at all. Rising levels of estradiol and estrone are. Synthetic progestins in HRT, and The Pill, are clearly associated with melasma, but not real progesterone. Many doctors will actually tell you toxic progestins are "progesterone". High estradiol and estrone levels are a major cause, along with the toxic synthetic ethinyl estradiol in The Pill.
Thyroid disorders are also clearly associated with skin pigmentation. Read the article Thyroid Balance. Your free T3 and T4 must be midrange, and not merely “in range” (e.g. 2.0 to 4.4 would be 3.2 midrange). Most doctors are not aware of this. You can test your free T3 and T4 at internet labs like www.healthcheckusa.com for about $100 with-out a doctor. Saliva thyroid kits don't seem to be available in 2023. Hypothyroidism is common in melasma, especially among people over 40.
Melasma is clearly associated with polycystic ovaries. Here the ovaries have multiple small cysts. Read the article Polycystic Ovaries (PCOS). Two thirds of women with mel- asma have PCOS. Cure your PCOS and you go a long way to curing your melasma. The hallmarks of PCOS are high testosterone, hirstutism (facial hair), obesity, and insulin re-sistance. These are the classic signs PCOS. Get a cheap, safe, effective sonogram to see if you have multiple ovary cysts. Never get x-rays, when you can use sonograms and MRIs. Just get a sonogram or color Doppler to diagnose PCOS. Hyper testosterone (and DHEA) levels can only be lowered by diet, lifestyle, and balancing your other hormones. Insulin resistance means your body no longer responds to normal insulin levels, so it makes ex-cessive amounts. This is caused mainly by the inordinate amount of sugars we eat. Read the articles Sugar is Sugar and Insulin Resistance, and my book The Natural Diabetes Cure to cure any blood sugar issues.
Women should, therefore, test their DHEA and free testosterone levels. They also need to test estradiol, estrone, and estriol levels. Men don't need to do estriol. You can test these hormones easily and inexpensively with ZRT saliva test kits. Women over 40 can use 25 mg of pregnenolone, and 1.5 mg (half tablets) of melatonin, as well as natural progester-one cream. Prolactin, LH, FSH, and estrogen metabolites are what they are, and do not need to be tested. Yes, high prolactin levels are clearly associated, but you cannot lower this with drugs. Only diet and lifestyle will lower excessive levels of these hormones. Men over 40 can use 50 mg of pregnenolone and 3 mg of melatonin. You want low normal estradiol and estrone levels, and high normal estriol levels. Just use natural progesterone cream, per your menstrual status, without testing. This is especially import-ant for women over 40. Men can use small amounts (i.e. 1/8th teaspoon) of progesterone cream daily.
Diet is central here. Read my book Macrobiotics for Everyone. You must eat a whole grain based American macrobiotic diet. This means whole grains, beans and legumes, most vegetables, only 10% fruits, and only 10% seafood, plus healthy soups and salads. If you are a vegan, just omit the seafood. No dairy foods, meat, eggs, or poultry. No nightshade vegetables (tomatoes, potatoes, peppers, and eggplants). No sweets or desserts.
There are 17 proven supplements for people over 40. Those under 40 would still want to take all of these for a year, or until they are cured. This includes CoQ10 100 mg, beta glucan 400 mg, vitamins, minerals, DIM 200 mg, lipoic acid 400 mg, vitamin D 400 to 800 IU, vitamin E 200 IU, beta carotene 10,000 IU, flax oil (rather than fish oil) 1,000 mg, FOS 500 mg, good acidophilus 6 billion units, glutamine 500 mg, PS 100 mg, NAC 600 mg, glucosamine 500 mg, sulforaphane 1 mg, beta-sitosterol 300 mg (optional). Read the article Serious Supplement Program.
Those under 40 should read the article Supplements for Younger People. All the above supplements are "endogenous", and found in our everyday food and/or our bodies. Minerals are vital here. Mineral deficiency is a cause of every known illness. Take All Your Minerals® with the 17 elements you need in the proper doses. Read the booklet The Minerals You Need.
You simply cannot take any Rx drug, with the exception of insulin for type 1 diabetes, temporary antibiotics for an infection, and temporary pain medication for injury. Do not use toxic, harmful, expensive creams like Opzelura®. The most commonly prescribed drugs in America are for cholesterol (statins), diabetes, in-fections, stomach acid, blood pressure, and depression. Countless prescriptions for Lipitor, amoxicillin, Lisinopril, Albuterol, Vicodin, Tramadol, Prednisone, Protonix, Lexapro and Metformin every year cause incomprehensible health damage. You cannot poison your way to health. There is a natural answer for all your illnesses. You must get off all prescription drugs, especially ones like Premarin®, progestins, birth control pills, and the anti-depressant and anti-anxiety drugs. Anti-depressant and anti-anxiety drug use is an epidemic with American women- 1 in 3 over the age of 50 in fact.
You need to realize no doctor on earth can help you. However, if you can find a good laser therapist you can do something here. That still doesn't deal with the cause. No drug or cream is going to cure this. In fact, these things will just make your skin worse. The cure is internal, not external. Deal with the cause, and not the outward symptom. Think holistic, whole body health, and not “skin pigmentation”. Men can follow this same basic program, (but do not need to test their estriol levels). People with vitiligo and other skin pigmentation problems can also use this program. Do the Seven Steps faithfully and you'll get well. That is the only real cure.