For many years women have been plagued by the discoloration of the skin known as Melasma. The pigmentation typically presents itself in a symmetrical pattern on the face either on the cheeks, upper lip, forehead, etc. It may start very faint especially in those with fair skin. Those with darker skin types especially Hispanic and Asian skin types may notice this more often and it may present itself darker.
Not only can pregnancy cause this skin condition but it has alsopbeen linked to birth control pills, oral acne antibiotics, anti-malarial medication as well as hereditary factors. Some people may notice it later in life and can attribute it to excessive sun damage to the deeper levels of the skin. Some people may also notice this after certain types of skin care treatments at spas.
So how can this condition be treated?
First, know that this condition has no long term effects or harm to the body. Treatment is completely cosmetic. Treatment in some individuals can be very costly depending on the severity of the case. Also note that all treatments are only minimizing the pigmentation and that with sun exposure and other hormone related issues the pigment can return or get worse. Our pigment cells called melanocytes have a memory and with any type of triggers they can, and will, release more pigment. That is why first and foremost sunscreen is a must! It is recommended you use more physical blocks such as zinc and titanium. Chemical sunscreens, which are most of the over-the-counter sunscreens, contain chemicals that can actually trap in the heat and stimulate worsening of the pigmentation. A favorite sunscreen for those with melasma is the Colorescience Sunforgettable powder sunscreen because it is a physical block but, unlike creams, it lets the skin breathe and does not trap in the heat. It is also very water resistant!
Prescription creams such as hydroquinones (4% or higher) and Retin-A are also a gold standard in caring for melasma although they can not be used while pregnant or breastfeeding. Hydroquinones work by suppressing the melanocyte cells so that they do not overproduce pigment. The Retin-A works by stimulating cell turnover which will bring the pigment to the surface to be exfoliated. Best results are found when these two prescriptions are used together. But be cautious, these are prescriptions and need to be used under physician supervised care and that hydroquinones are not intended to be used daily for the rest of your life. It is best to be used short term and then intermittently as pigment returns.
Certain types of peels such as TCA peels, certain lasers such as IPL or BBL, and light resurfacing treatments are also used to speed up the process of evening out the tone of the skin.pAlthough, there are small risks associated with these deeper treatments such as scarring or worsening of the pigmentation. Regardless of anypin-office treatments, it is always recommended you pretreat with hydroquinones and Retin-A (such as Tri-Luma cream) prior to treatment and resume when your skin care specialist or physician recommends.
Whichever option you and your skin care specialist or physician choose, be aware that your treatments are only minimizing the pigment and that you will always be working on maintaining the health of your skin. Discuss with your physician and don’t forget that sunscreen and minimizing sun exposure is #1 in preventing and maintaining your melasma.
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