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Many Latinas dread hot summer days since they’re a leading factor in paño/manchas, or facial dark spots.

Spots –– whether in the form of leopard prints or polka-dot bikinis –– are a great fashion accessory, but not when they’re worn on your face!

Let’s face it: skin and appearance are top priorities on any Latina’s list, and the common skin condition can often place a dark spot on confidence and self-esteem.

The subject of paño was recently brought to light by our very own MÁS beauty columnist, Denise Ornelas, in our July 13 issue, so we decided to go more than skin deep for more information concerning the pesky spots.

Paño or manchas are slang terms that describe the common skin condition called melasma, where discoloration and dark spots appear on sun-exposed areas such as the cheeks, upper lip, chin, and forehead.

MÁS talked to Bakersfield dermatologist, Susan Luu; and a specialist in aesthetic and aging management, Dr. Milan Shah, to understand and gather possible treatment options for the condition that, according to the American Academy of Dermatology, affects 5 to 6 million people.

“Those who are most likely to get melasma are Spanish, Asian, or Middle-Eastern women, in that order,” explained Luu.

The increased amounts of melanin, or darkening agent, found in most Latina’s skin makes them more susceptible to melasma. The prevalence of sun in Bakersfield can also bring higher risks for local Latinas.

The other significant affected population is female patients who are taking oral contraceptives or are pregnant. That’s why melasma can also be referred to as “mascara del embarzo.”

The clinical term for the “mask of pregnancy” is cholasma, and is synonymous with the symptoms of melasma.

Birth control pills contain chemicals that cause sensitivity to light as well as other medications. Make sure to read the fine print on the informational pamphlets and take proper precautions.

“Melasma is a hormonal condition. Levels of hormones are constantly changing,” Shah explained.

Griselda Gonzales, a 55-year-old who regularly visits family in Bakersfield, has been plagued by melasma since her 40s and has experienced lower confidence in social situations as a result.

“I probably noticed the spots when I hit menopause. I have tried using my abuela’s recipes of lemon juice and glycerin, but they never worked. I really get embarrassed when people stare at my face and often tell me that it looks like something is on my face, but it’s just the spots,” Gonzales said.

To combat more severe forms of melasma, Luu and Shah stressed the importance of taking preventive measures.

Luu’s prevention tips for melasma include wearing sunscreen on a daily basis and getting treatment as soon as possible.

Shah agreed that sunscreen is the No. 1 preventive measure individuals should employ.

“You want a sunscreen that is broad spectrum, at least SPF 30 that contains both UVA and UVB protection. You should also look for sunscreen that contains titanium oxide or zinc oxide, they provide more protection,” Shah said.

The more sunscreen the better ––  there are many more on the market than ever before.

Clothing brands, such as SunGrubbies or Coolibar, with sunscreen infused into the fabric, or easier-to-apply sunscreens like Coppertone, which comes in a spray can, make it simpler to stay protected from the sun.

One of the biggest mistakes Latinas make is assuming that because we don’t have light skin, no sunscreen is necessary, which couldn’t be further from the truth. The truth remains that melasma appears gradually. For example, it can take four to five years to appear and another four to five years to go away. It rarely fades on its own.
“You should not expect it to go away fast,” Luu said.

Like Gonzales, most Latinas attempt over-the-counter or homemade recipes to treat paño. But  according to our experts, it only harms the skin more. Over-the-counter bleaching creams such as those sold by Neutrogena or Clinique may treat minor melasma that is only on the surface, but not deeper melasma, since the melanin is stored in the under layers of the skin.

Luu and Shah both mentioned skin bleaching ointments as the primary treatment options for melasma, as well as chemical peels and laser treatments. Luu recommends persistent use of products such as TriLuma –– a prescription-based skin bleaching ointment that contains 4 percent hydroquinone, tretinoin, and flucinolone acetonide. The product runs around $75 dollars, but will last for several months.

“Products with hydroquinone are the best and most reliable treatment for melasma,” Luu stressed.

Shah endorses another weapon against melasma, a line called Obagi Nu Derm.

“I see about 600 patients, and 99 percent of them see dramatic improvement in months with the product. It is the combination of the six steps that does it for them,” Shah stated.

Obaji Nu Derm stops the production of melanin, which causes the discoloration from the melasma, as well as exfoliates the skin by using retinols, Shah explained. The Obagi Nu Derm products cost about $500 and last about four months. That price includes all follow-up visits and medications.

If melasma cannot be treated with bleaching creams, the next step is chemical peels or masks. Shah spoke of a blue peel made by Obagi Nu Derm that works to treat hard-to-get-rid-of melasma. It is a 25 percent TCA peel that controls the depth of melasma. The peel is used to help with melasma deeper within the skin where the bleaching creams can’t reach. The peel with Shah will cost around $600 and most often is used in sync with the Obagi Nu Derm regime.

The third treatment option mentioned was laser. Laser treatments rank lower on Luu’s list because of the unreliability.

“I once had a patient from Thailand and she had deep melasma. Her American boyfriend decided to take her to get laser treatments and the melasma worsened. Sometimes the laser can harm more than treat,” Luu stated.

Laser treatments are not the place to start when treating melasma, Shah also stressed.

“You shouldn’t start with laser treatments because we are dealing with dynamic hormone levels that change,” Shah said.

Most of the treatment options are not covered by insurance because they are considered cosmetic. However, the benefits of self-confidence are priceless.





What you should expect on your first visit to the dermatologist
A trip to the dermatologist is nothing to be worried about, so no more biting your uñas. Dr. Shah gave MÁS an idea of what to expect:

• 1. First, the doctor will need your basic history and your specific concerns about your skin.

• 2. Second, the duration of the condition will be needed to help analyze possible solutions.

• 3. Third, If there is a family history of melasma, make sure to mention that to your doctor.

•  4. Fourth, a physical exam will be given to evaluate the pigmentation of your skin and the level of the condition.

• 5. Lastly, the doctor will develop a personalized skin system to treat your needs and emphasis persistence and follow-up visitations.