Melasma

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Identification

What is Melasma

Melasma is said to be a form of pigmentation on the face usually mistaken for a tan. Melasma often appears around the cheeks, forehead, upper lip, nose, chin, and jawline. It also may appear on the forearms, but this is quite rare.

Although it is most common in women of childbearing age, you don’t even have to be woman to be afflicted. Up to 10% of Melasma cases are shown in dark skinned men. Although there is no real cure, there are steps you can take to avoid it, minimizing the visible effects and keeping skin pigmentation spots at a minimum. Successful treatment usually begins with the trio of:

  • sunblocks
  • bleaching creams
  • time

Melasma Pregnancy Mask Syndrome

The melasma pregnancy mask syndrome (MPMS) primarily impacts Latino and Asian women, producing darkened coloring spots on the face. Skin inflammations from allergic reactions can also be a trigger, in addition to a predisposition to MPMS. Waxing of facial hair (especially above the lip) can also be a trigger. Some medications can be included in the causes, such as antibiotics like tetracycline, and some anti-seizure and anti-malarial drugs.

Causes of Melasma

The specific cause of melasma remains unknown, but it is believed to be due to an increase in the production of cells. This releases the pigment melanin, which is responsible for the dark color of the skin.

What causes the increased production of melanin is not known, but some factors are:

  • Heredity factors and hormone fluctuation/production: the rash is most common in pregnant females
  • Prolonged sun exposure
  • Use of birth control pills
  • Certain medications like tetracycline and anti-malarial drugs (derived from quinine)

Melasma is not related to any medical disorder. By itself, it is a harmless skin condition despite the cosmetic concern associated with its appearance on facial skin.

Diagnosing melasma in pregnant women is relatively simple. When diagnosing in men, and women who are not pregnant, drug related skin reactions and other medical conditions might have to be ruled out. A skin biopsy may be performed for diagnosis in some cases.

Melasma is usually a transient skin disorder that may resolve itself. This may occur after childbirth in pregnant women. In cases where the melasma occurs in men or non-pregnant women, it may exist for a few months to a few years and then suddenly disappear. Thus, treatment is not always warranted and it is difficult to know when the rash will remain and in whom it will disappear.

Prevention

Being aware of the health of your skin is a major responsibility. Try to avoid drying your skin out, as well as over moisturizing it. It is a good rule of thumb to avoid sun exposure, but the use of sunscreen daily (with SPF 30+), while taking the appropriate supplements to counter the sun’s rays, ensures both your inside health and outside appearance are as good as they can be.

Melasma Over Time

The good news is that melasma symptoms tend to fade over time, usually a 3 to 4 month period after initial manifestation. Chemical Peels offer a relatively successful and controlled short-term strategy to the facial areas affected by melasma.

Complex factors may trigger melasma in women, as well as the 15% of men that are afflicted. Topical creams have been known to have great results, as have skin bleachers, laser skin resurfacing, and chemical peels. These all provide positive results.

Left alone, and not intensified by sun exposure, melasma tends to stay around for less than a year. Impacted skin cells with the discoloration are “surface” cells, and melasma becomes “permanent” is if the discolored area splits, allowing these hyper-pigmented cells to go deeper into the skin layers. When the discolored cells with melasma are settled within your deeper dermal tissue levels, they resist conventional treatments.

Treatment

[sws_pullquote_right]“Chemical peels can be applied to remove age spots, melasma, freckles, wrinkles, and fine lines.”[/sws_pullquote_right]
The best treatment for melasma is prevention. Please review the previous section if you have not already. In summary, the key to preventing melasma is sun avoidance and daily sunscreen use. However, for most of us, it is too late for prevention, and there are a number of treatment options available.

Chemical Peels

Chemical peels can be applied to remove age spots, melasma, freckles, wrinkles, and fine lines. They may:

  • smooth and firm the skin
  • and lighten dark areas gradually.

The superficial peels, such as a glycolic acid peel, can be done during your lunch hour, and there is no recovery time. Deeper peels are more effective but require longer recovery. See more details under the discussion chemical peels.

Treating Melasma with Chemical Peels

After prevention, the best treatment for Melasma consists of a combination of bleaching and exfoliation.

Bleaching is not a fast process. Depending upon how dark the area is compared to the normal skin tone, it can take as long as one year or sometimes longer, but normally you will notice results within several weeks.

[sws_pullquote_left]”By adding exfoliation (glycolic peels) in combination with hydroquinone, you can hasten the resolution of melasma.”[/sws_pullquote_left]The glycolic acid works to remove superficial pigmented skin cells and it also eases penetration of the hydroquinone.

We recommend using a 2% or 4% hydroquinone twice daily and combine that with weekly glycolic peels. It is important to avoid sun exposure and use an SPF 30+ sunblock when you will be exposed to the sun. Sun exposure will cause the brown pigment to reappear.

The 4% hydroquinone is only available with a doctor’s prescription.

What are the risks?

Different kinds of peels carry different risks. Superficial peels are usually quite safe. However, you may need a series of superficial peels (done approximately once a month) before you’ll notice improvement. Costs can add up if you choose a series of peels.

The risks and benefits vary depending on the kind of peel. They should be discussed in detail with your physician.

Skin Laboratory Peels an Melasma

Our HQ+ peel has been specifically designed to provide a deeper peel. Thus HQ+ can better remove melasma and inhibit new pigmentation. The lactic peels are also very effective at fading pigmentation.

In treating melasma, stronger peeling agents tend to have a higher effectiveness rate than lighter strength peeling agents. Stronger peeling agents may also carry the risk of side effects such as burning, skin peeling, scarring and even worsening the skin discoloration.

No matter what you choose, sunscreen is a must. No treatment for melasma will be successful without sunscreen. The best sunscreens are those which are mineral based, such as zinc and titanium.

Skin Lightening Agents

There are many skin lightening agents on the market and the most commonly used is hydroquinone. Numerous other agents sold in herbal and nutrition stores may work as skin lightening agents as well, however each patient has a unique skin type, and reactions to skin lightening agents vary.

These treatments do not necessarily cure the cause of melasma, and the effectiveness of each will vary from patient to patient. Even after treatment, skin discoloration may not always disappear completely. Thus each patient may have to try various treatment options to see a satisfactory result. Some treatments may have to be continually performed to sustain results, such as applying a skin-lightening agent on a regular basis, combined with effective sunscreen usage and sun exposure avoidance.

To help prevent melasma from worsening, patients may wear sunscreen, which contains a mineral-based shield from the sun with an SPF at least 30. Protective clothing and wearing a hat may help to prevent melasma from worsening. Protective facial makeup may also be worn to help even skin tone and block out the sun. These days some cosmetics even have a small amount of SPF.