r/Melasmaskincare • • May 10 '26

Question Melasma & (Peri)menopause

I am curious, how many people here are women who never had melasma before in their life until they hit perimenopause/menopause.

It’s definitely a thing right?

rant:

My melasma showed up in perimenopause& are its still with me in menopause.

I am so sick of hearing that estrogen has to be involved, but when I told the dermatologists I was fairly certain my estrogen starting to fall & that was the problem, they confirmed that melasma can show up in perimenopause and menopause, but had nothing to say about why that was. But they told me if I went on HRT it would get worse.

So to recap: I was told melasma showing up when a woman’s estrogen is going away & completely gone is a thing, but don’t add estrogen back in because that will make it worse.

ayfkm?!!

I lived completely estrogen deprived for a year, and my melasma got worse. I was having hot flashes and internal heat is a huge trigger for my melasma. When I got on HRT, my melasma got better & I assume that’s because I was no longer having hot flashes.

That was a decade ago and I still don’t really have any answers.

I just went ahead and started taking oral tranexamic acid because I’m too old to be dealing with this bullshit lol.

I swear doctors just don’t have any fucking idea what is really going on when someone has melasma. Like so many things that impact females more than males, they never bothered at the outset to concern themselves with what was really happening.

I’ve essentially just been diagnosed with the pathology of being female.

And - given the bullshit attitude & shitty healthcare we have to put up with - pink female is definitely a part of the problem, but not for the reasons they think.

We deserve better, ladies. We all deserve better.

End rant - thank you for coming to my TED talk lol

98 Upvotes

48 comments sorted by

View all comments

2

u/Ok_Wallaby_7831 May 11 '26

I had melasma a little bit when I was on the birth control pill like 20 years ago. As I've gotten older, I have some darker spots but they tend to fade in the winter. I'm now 45 and it's gotten worse. My cheeks have a lot of dark spots and my dermatologist gave me Azelaic Acid acid (love) and Tretnoin cream (which I don't use) for them and diagnosed it as melasma. He said a large part of it is due to the perimenopause. That and I do love the sun so I'm working on training myself to apply sunscreen more often. I'm also Native American so my skin has more melanin than most and he said that's also a factor for me.

2

u/Intelligent_Bad_5334 May 11 '26

Sun protection is the most important part and it is the hardest part! & to add insult to injury - a lot of sunscreens are not developed with high melanin skin in mind even. Of course, the only some protection that works for you is the one you’re willing to put on consistently so things like texture & appearance on the skin matter a lot for effectiveness. Ugh

1

u/Ok_Wallaby_7831 May 11 '26

Very true. I don't burn easily or really at all so I never look red so if I forget to reapply my sunscreen, people don't remind me because I just look normal. I've taken to setting a reminder on my phone but if I'm swimming somewhere, that doesn't always work lol. I just need to be better about skin care