Most people are surprised when they hear that skin pigmentation is regulated in the brain and not just in the skin.

The stress hormone cortisol has two precursors: ACTH, and alpha-MSH (the latter being the main pigmentation hormone). Both are produced in the pituitary gland. A small but mighty hormone-production factory in the brain.

I am suggesting that the melasma-brain connection is the reason this skin condition shows up symmetrically. No matter if a patch is on the forehead, the upper lip or the cheeks, melasma appears on both sides of the face, as opposed to a random one-sided spot from radiation damage. As if it is controlled by an organ that sits in the center of the body.

Every single woman with melasma I have worked with has experienced intense stress or severe emotional trauma prior to their melasma “debut”.

Here are 3 reasons why emotional stress contributes to melasma:

1 Progesterone Steal

The stress hormone cortisol and the sex hormone progesterone come from the same precursor, pregnenolone. During times of high stress, your body automatically produces more of the stress hormone cortisol. In order to keep up with the cortisol demand, the body has to “steal” pregnenolone from progesterone production.

In other words, during ongoing stress, pregnenolone prioritizes cortisol over progesterone production. This results in low progesterone levels and a slight estrogen dominance with symptoms similar to high estrogen levels, for example, melasma (!).

2 Adrenal Burnout

When stress becomes chronic, the adrenal glands become too tired to produce sufficient stress hormone (cortisol). When this happens, the feedback loop that keeps hormones balanced is disrupted.

Without sufficient cortisol from the adrenals, the pituitary gland in the brain doesn’t receive the signal to stop producing its precursor hormone (POMC). The overproduction of POMC leads to excess alpha-MSH and ACTH in the blood circulation—both hormones stimulate melanin production in the skin.

When the sun hits, the skin receives an overwhelming overload of stimuli from pigment stimulating hormones and radiation, which results in an overproduction of pigment.

3 Pre-hormones Change Your Cells

ACTH enlarges melanocyte size, creates more melanocyte connection sites (dendrites), and increases the enzyme tyrosinase—all 3 are typical features in melasma.

What shall we do about this? Isn’t stress normal?

Yes! It’s ubiquitous, and I believe stress isn’t just bad. Stress strengthens our stamina. There is no growth without stress. But important is the recovery time. If we don’t recover after a busy day, we damage ourselves.

Here some questions for you:

How would you rate your stress levels?

Are you go, go, go?

Have you processed your traumas?

Are there things that keep you up at night?

Is it time to get your hormones checked? The DUTCH test is a comprehensive hormone test that can shed light to your situation.

Or is it time to seek some help for deep emotional healing?

So many questions…

In the meantime, take some deep belly breaths. Give yourself some rest. Be “lazy”, the laundry can wait till tomorrow (I know it’s hard). But you and your skin deserve it!

Read more about the root-causes in The Truth About Melasma.

If you are interested in books and practitioners that could help with emotional stress, please leave me a comment.