Melasma Misery in Middle Age
and how Filipino beauty standards affect me
Melasma is a skin condition in which your face develops dark splotches due to hormones, genetics, medication, sun exposure, and possibly more, like hypothyroidism, or if you’re lucky, all of the above. Some women get it when they’re pregnant or taking birth control pills; others, like me, develop it in middle age. I was in perimenopause when it began showing up on my cheeks five years ago. My “before” picture (above) isn’t the greatest, but you can see the dark patches on my cheeks.
These patches can be dismaying and rarely go away on their own. Some people use over-the-counter products to treat it, but I needed to see a dermatologist who prescribed prescription-strength hydroquinone medicated pads and tranexamic acid, which is taken orally. According to the National Institutes of Health, “Hydroquinone acts as a skin depigmentation agent by inhibiting melanin synthesis.” Tranexamic acid is a blood thickener but is used off-label to treat melasma. Though they don’t know for sure how that works, there are theories.
According to my dermatologist, you can only use these medications for three months at a time because using them too often makes the condition worse. So for me, it’s three months on, three months off to give my skin a break. I anticipate my doctor will put me back on these medications in May or June.
Melasma usually gets worse during the summer months. I don’t spend a lot of time in the sun, but I haven’t been very good at wearing a hat when I do go out. But I recently bought one that’s made of SPF 50 fabric. I just have to remember to wear it! I also use an SPF 50 mineral sunscreen, even on cloudy days, that blocks rays instead of absorbing them like chemical sunscreen does.
I no longer bother using foundation to cover up the melasma, because I’d had to use a lot, and I don’t like how it feels on my face. I also don’t like tinted sunscreen because it has never fully covered up the patches and feels thick on my skin. And it looks gross on a makeup remover wipe when you remove it.
I used to care more about my appearance when the patches first developed because it was like someone tried to paint my face but didn’t finish the job. With treatment (above), it’s cleared up, though not completely.
The methods I’ve described are not like the “whitening creams, whitening pills, and whitening treatments” frequently advertised in the Philippines, according to Mariel De Los Santos in her essay, “Full-Colorism Television.” Lighter skin is valued in Filipino culture, largely due to colonial mentality (all things Western/white are better). Also, “ There is a misconception that Filipinos with darker skin work outside and are therefore ‘lower class’,” writes Maika LLaneza in “Comfortable in My Own Skin.”
I must admit that I come from a family of privileged, lighter-skinned Filipinos. Still, my mother used to admonish me to cover up when going outside because of what other Filipinos might think if my skin grew dark. She was always concerned about my physical appearance, criticizing my facial features, particularly the size of my lips. To this day, I worry about how I look and am self-conscious about my lips. Thankfully, she’s no longer around to find fault with my melasma.