Psychosomatics of melasma
Melasma is brown patches on the cheeks, forehead, nose and upper lip. It is more common in young women and is linked to hormones: pregnancy, the contraceptive pill, hormone replacement therapy in menopause, and to the sun. After the birth the patches often fade. The Ladder method adds questions about how you see yourself through other people's eyes, and it does not replace a doctor.
Updated
When to see a doctor
A dermatologist looks at dark patches. The doctor examines the skin, sometimes under a special ultraviolet lamp, and tells melasma apart from other spots. If hormones are involved, a gynaecologist or endocrinologist joins in. Treatment is chosen for your skin type.
In the Ladder method
In the Ladder method dark patches are not explained as "you do not love yourself". You are not to blame. A dermatologist looks at them first, and sun protection comes first. Questions to yourself belong next to treatment, not instead of it.
Read more
In the method the skin of the face fits the image of "how I am seen": how much it matters to you what others think, whether you can let yourself look imperfect, and what you feel looking in the mirror. Many women hide patches under foundation for years after pregnancy. It is an image, not the cause, and it does not replace treatment.
On the ladder this shows up as the steps "they will judge me" and "I have to look flawless". You can work through them at your own pace alongside skin care.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
More: signs, medicine, sources, questions
How it shows up
Book a doctor’s appointment if you notice:
- Brown patches on the cheeks
- Patches on the forehead and nose
- A dark band above the upper lip
- Patches that are the same on both sides
- They get darker in summer and in the sun
- They appeared in pregnancy or on hormones
What medicine knows
MedlinePlus says melasma is a common skin condition that causes dark patches on areas of the face exposed to the sun. It most often appears in young women with brownish skin, but it can affect anyone.
Melasma is linked to the female hormones estrogen and progesterone. It often appears during pregnancy (it is called the "mask of pregnancy" or chloasma), in women taking the contraceptive pill and in those on hormone replacement therapy in menopause. The sun makes it more visible.
The only sign is a change in skin colour: even brown patches, often the same on both sides, on the cheeks, forehead, nose or upper lip. The patches do not hurt, but MedlinePlus notes they can cause distress about appearance.
It is treated with creams containing lightening substances, chemical peels and, for severe melasma, laser. Sometimes the doctor suggests stopping hormone medicines. The patches often fade over several months after the birth or after stopping hormones, but they can come back. The main protection is sunscreen every day, a hat and shade.
Sources
Frequently asked questions
Why do dark patches appear on the face?
Melasma is linked to the hormones estrogen and progesterone and to the sun. It often appears in pregnancy, on the contraceptive pill and on hormone replacement therapy in menopause (MedlinePlus).
What does melasma mean in psychosomatics?
There is no proven "meaning". In the Ladder method melasma becomes a reason to ask yourself how you see yourself through other people's eyes. It is a question to yourself, not a diagnosis.
Will the patches go away after pregnancy?
Melasma often fades over several months after the birth, but it can come back in a later pregnancy or with sun (MedlinePlus). Daily sunscreen helps, and for stubborn patches a dermatologist chooses treatment.
Related topics
Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.