Melasma can be an exasperating and mysterious skin condition . Women by far, are more likely to be affected by melasma. Only approximately 10% of cases will occur in men. Often referred to as the “pregnancy mask”, it is implied that melasma is more prone with hormonal fluctuations such as seen in pregnancy, menopause , the use of hormonal replacement therapy or with contraceptive methods containing estrogens and progesterones.
Melasma presents with areas of skin discolorations in dense patches on the forehead, bridge of nose, chin, cheeks and upper lip. People with darker skin, descendants of the Mediterranean areas, Hispanics and Asians are more likely to get melasma, suggesting a genetic factor.
Melasma can be found in the upper surface of the skin ( epidermis) or in the deeper layers (dermis) or a combination of both. This will dictate the ease and length of time requiring treatments.
Ultraviolet light exposure from the sun, can stimulate the melanocytes, so just a small amount of sun exposure can make melasma return after fading!
Are you a Candidate for Melasma Treatments?
For some individuals, the cessation of hormone-altering therapies and the normal rebalancing of hormones after pregnancy can cause melasma to fade on its own. For others, unfortunately, melasma can be persistent and remain pronounced indefinitely if not treated.
Treatment includes a combination of medical-grade skin care products for daily use and professional treatments of chemical peels , laser therapy and /or microneedling.
Skin care regimens must include a triad of topical therapies, including ingredients that suppress the formation of excess melanin ( the color producing cells) such as hydroquinone, kojic acid and some botanicals such as arbutin, licorice, and mulberry, topical Vitamin A products ( retinols) to boost cell turnover and help accelerate the lifting of pigmented cells and antioxidants such as Vitamin C and an effective broad-spectrum sunscreen.
Medical-grade peels , such as the ZO 3-Step Peel and the RevePeel Fresh Peel have a low concentration of TCA and lactic acid, , known to safely treat the deeper dermal melasma without triggering unwanted inflammation and worsening outcomes. These are the safest options for darker and ethnic skin individuals as well. Often IPL (intense pulse light ) therapies can worsen the condition by stimulating an increase in the melanin as the skin responds to the heat trauma. Laser therapies that bypass the melanocytes in the upper layers of skin, such as the Laser GENESIS, use rapid micro-pulses to effectively eliminate excess melanin.
Micro-needling has proven to show benefits in treating melasma by enhancing the delivery of topical products to the dermis and encouraging new collagen production.
What to Expect with Melasma Treatments
The different types of melasma are epidermal, dermal and mixed , with the epidermal type being the easiest to treat. A daily regimen of home skin care is essential for the best outcome.
After the melasma clears, a stringent regimen of year-round skin care is necessary to inhibit the return of hyper-pigmentation. Daily sunscreen and gentle chemical peels can provide immense correction of this stubborn condition.
Since overtreatment of melasma will worsen the condition, a gentle, multi-pronged plan approach is best to fight this vexing condition. Laser Genesis, microneedling and the blended medical -grade peels are considered mild therapeutic treatments and render little to no downtime.