As far back as the ancient Greeks, people have documented a funny phenomenon among pregnant women: The skin on their faces sometimes changes color. Scientists never quite knew why that happened, though they suspected that it was linked to the spike in the body’s hormones during pregnancy. Now, a new study published this week in eLife found that two sex hormones, estrogen and progesterone, play a key role in regulating the body’s synthesis of melanin, the substance that gives skin pigment.

To test the relationship between hormones and skin pigment, the researchers administered doses of the hormone estrogen to a 3D array of cells designed to mimic the structure of human skin. The longer the cells were exposed to oestrogen, the more melanin they produced; after four days, the cells produced up to 300 percent more melanin than before they were exposed to oestrogen. The researchers did the same test with progesterone (a synthetic version, progestin, is in oral contraceptives), which the body also produces during pregnancy, and found that cells decreased their melanin production when exposed to that hormone.


That was intriguing, since the melanocytes (the cells that produce melanin) don’t have traditional hormone receptors.

When the researchers took a closer look at the molecular pathways, they discovered that the hormones activate special pathways in the melanocyte cell membranes that tell the cell to create more or less melanin.

Now that we’ve uncovered the reason why we women are being inflicted by melasma, the mysterious dark patches that creep up on our cheeks with or without sunscreen, we’re in a better position to battle it. Here are the top skin pigmentation treatments ranked in order of efficacy…

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No. 1 Lasers


Lasers can help melasma when done judiciously and in expert hands. Too strong a laser can trigger some nasty burns and too gentle will produce no results. Unfortunately, there is not one laser which can successfully get rid of melasma, so the optimal results are usually produced by medical practitioners who use a combination of different lasers to target pigment cells sited both superficially and deeply. Unfortunately, many a woman have been subjected to a multiple sessions of a single laser by doctors with limited resources and hence come away with the mistaken notion that melasma cannot be improved by lasers. Women who have had their melasma successfully lightened swear by a combination of skin renewal lasers such as Fraxel Dual, BB Aquatouch as well as Pico Pigment lasers. The final secret ingredient is the diligence and regularity at which these patients undergo the treatments. It also appears that multiple regular sessions of mild to moderate powered lasers seem to do better than single sessions of strong lasers, especially for dark skin types. That’s something definitely worth keeping in mind.

Read More: How to Get Brighter, Clearer Skin in 20 Minutes or Less


No. 2 Vitamin C Therapies


Vitamin C has long been touted as a natural skin brightener and lightener. The main issue with vitamin C is how active the vitamin is in serums and creams when it is finally delivered to the skin. Vitamin C is notorious for its degradation over time, accelerated by ambient factors such as UV and temperature. This perhaps contributes to the varying results experienced by ladies who apply vitamin c to their skin. One of the ways to overcome the issue of vitamin C potency is to undergo an in-clinic vitamin c therapy. In the form of Plasma C boost, SW1 Clinic has devised a way of delivering vitamin c using sonophoresis to the skin. The vitamin C comes in a fresh powder which is activated upon mixing only at the time of the treatment. Sound waves also amplify the penetration potential of the mixture, resulting in higher concentrations in the skin. Like lasers, regular sessions will yield optimal results for a chronic condition like melasma, though socialites have been known to use this as a single session skin pick-me-up as vitamin confers a myriad of other benefits such as glowing skin and anti-aging benefits.

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No. 3 Chemical Peels


Chemical peels are one of the oldest therapies around yet there is still a place for them when it comes to lightening skin. If budget is a concern, then turn to chemical peels for a quick skin exfoliation effects. Jessner peels and glycolic peels are most effective as they can help to renew the dead cell layer of the skin, resulting in brighter skin. After a chemical peel, skincare ingredients are unhampered by the removal of dead cells, thereby penetrating the skin with greater efficacy and intensity. Of concern is the sensitivity of the skin to sun post-treatment, but this is easily negated with a judicious application of sunscreen, which surely must be a staple of any women’s beauty regime by now.

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No. 4 Topical Skincare


While this sits right at the bottom of the list in terms of efficacy in clearing pigmentation, there is something to be said about its vital role. Skincare are typically less expensive and accessible to most women, and hence must be considered if one were to be serious about treating melasma and keeping it away for the long haul. However, there is a difference as vast as day and night between skincare ingredients, and prescription based skincare tend to work far better than OTC products. The ingredients that truly stand out are mequinol, vitamin A, arbutin, kojic acid and tranexamic acid. Add to this line-up a prescription sunscreen like Umbrella, formulated for post-laser sun protection, and it’s possible that even the most stubborn of darkened skin will see the light of day in due course.

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