Melasma, derived from the Greek word Melas meaning "black", refers to a patchy or generalized dark pigmentation of the skin. It's presence is predominantly seen in females and at times induced by hormone fluctuations, i.e: pregnancy, while on the birth control pill and/or while taking photosensitizing medication, e.g; acne medications, anti-depressants and diuretics. However, it's appearance in males is not uncommon and can be just as challenging to control.
Here are some of the best treatments to tame your melasma and keep it at bay:
Hydroquinone, Tretinoin & Hyrdocortisone - Hydroquinoneis a compound widely used in cosmetics for its ability to decrease the skin color, leading to whitening. By affecting the synthesis of the pigment melanin, it can gradually bleach the skin, thereby treating unwanted dark spots; Tretinoin helps to increase the penetration of hydroquinone through the outer skin (stratum corneum), while also preventing the oxidation of hydroquinone, thereby enhancing its effects; Finally, hydrocortisone is added for its anti-inflammatory properties. It helps to lessen inflammation on the skin.
Kojic Acid - It is a mild inhibitor of the formation of pigment
Arbutin - It inhibits tyrosinase and thus prevents the formation of melanin
Vitamin C - Known to both inhibit melanin formation and reduce oxidized melanin
SilkPeel Dermal Infusion Microdermabrasion - Combining the highest quality, diamond assisted microdermabrasion with a simultaneous delivery of potent topical serums, like the Lumixyl for hyperpigmentation deep into the surface of the skin and down to the base of the pores, SilkPeel, has been formulated into a solution for the treatment of hyperpigmentation issues on the face, chest and other parts of the body.
Chemical peels - Combining 14% Resorcinol USP, 14% Lactic Acid USP & 14% Salicylic Acis USP, the SkinTx Jessner Plus chemical peel can be an effective exfoliating treatment to rid of the skin of superficial sun spots.
Microneedling - This treatment provides an effective physical method of enhancing transdermal delivery of topical ingredients for various skin conditions without causing heat on the skin. The needles range in length and can penetrate into the skin up to 2 mm. This not only stimulates collagen production, but also facilitates the penetration of corrective products through the epidermis.
From the desk of Dr. Balharry...
One of the most common concerns that people have with their skin is pigmentation. This can be anything from a nuisance, to an embarrassment to a worry about cancer changes. Our skin is made up of many different types of cells and one of these cells is called a melanocyte. In fair skin, these cells lie quite deep in the dermal layer and increased in their activity and density under stimulation from UVA B radiation from the sun. This is protective function to screen the other cells in the skin from damage from the UVA B. That is how we ‘tan’. Unfortunately, this process is only protective up to a point and the repeated sun exposure creates a situation where some of the melanin cells combine in the skin layer and form brown patches, often called ‘sun spots’. To make this even more difficult, some ‘sun pots’ have a fairly constant and persistent pigmentation whereas others (freckles) will vary in their colour with sun exposure.
Trauma to the skin can often leave areas of hyperpigmentation. We see this most commonly after acne as the acne scars can have a darker pigmentation at their base. Even repeated waxing of upper lip hair may cause pigmentation changes over time. And then, there’s melasma. Melasma is thought to be a hormonal pigmentation. It can occur in anyone but it is much more common in females. In pregnancy, this is called ‘the mask of pregnancy’ due to the brown distribution over the cheeks and forehead. The pigment cells with melasma can be at different depths in the skin which makes it very difficult to treat.
The underlying cause for much of the pigmentation that we see is sun exposure. Different types of pigmentation have different treatment options. The superficial sun spots can be removed with topical creams, microdermabrasion, chemical peels, lasers and IPL (Intense Pulse Light). Unfortunately, they do have a ‘memory’ and will darken again with sun exposure over time. Melasma is certainly the most difficult pigmentation to treat, particularly if it is deep. The best option usually is to use lightening agents alone or in combination to help to fade the colour. Laser treatments can work but require treating quite deeply which can mean a few days of recovery time. It is often best to treat these conditions in the winter months and to be as protective as possible in the summer months to prevent the rate of recurrence. Good sunscreen well applied and/or preferably a sun block, such as the Jane Iredale topical powders, wearing a hat are all good ways of helping to prevent recurrence. If there is a lot of discolouration or a new spot arises that grows rapidly or an existing brown spot that changes size, shape or colour, be sure to have it checked. Enjoy the summer but protect your skin.
Gina's Skin Care Tips...
As mentioned above in the topical remedies paragraph, hydroquinone is commonly used to effectively reduce the appearance of melasma. It is suggested to only use hydroquinone for a few months at a time but can be used again as the pigmentation returns. There are plenty of other effective and safe ingredient alternatives that can be used every day to help even your skin tone and control melanin activity. Vivier’s new ‘Radiance Serum’ contains Arbutin which is comparable to hydroquinone and is combined with resorcinol and pharmaceutical grade vitamin C. Dermalogica’s PowerBright TRx line consists of three potent products designed to slough of existing pigmentation and prevent new hyperpigmentation from forming. Ingredients include Oligopeptides, red and brown algae, zinc glycinate and pumkin enzymes to name a few.
Because melasma is difficult to treat, it is crucial to be using products such as the ones listed above every day in combination with an effective sun protection. Mineral sun protection found in the Jane Iredale line is an easy way to ensure you’ll be protected all day without the hassle of remembering to reapply unless you sweat or wash it off.