Melasma: Persistence and Protection is Key to Treatment
Melasma, also called Chloasma, is a condition of the skin seen as brown pigmented patches appearing on the forehead, upper lip and cheekbones, or any other sun-exposed area of skin.It is commonly seen in young women who are pregnant or taking birth control pills, however hormonal imbalance or ovarian disorders may also trigger its development.This condition may rarely be seen in men.
People who have light olive to very dark olive skin are particularly susceptible to Melasma.Exposure to the sun’s UVA (ultraviolet A) and UVB (ultraviolet B) rays plays a large part in the formation of these tenacious pigmented areas.Light from common light bulbs can contribute by stimulating pigment-producing cells (melanocytes).
This condition may affect the epidermal (outer layer of skin) or the dermal (inner layer of skin) layers of the skin.Although there are many treatments for Melasma, there is no permanent cure.The goals of treatment remain the same: to control and minimize pigmentation.Treatments should be used in combination and aggression may be required.There are both over the counter and prescriptive products available for use.
The first line of defense against Melasma is sun protection.Because the skin is constantly bombarded by sunlight, it is essential that people who suffer with this condition protect themselves as thoroughly as possible from sun exposure. Sunscreens with an SPF of 30 or higher are recommended, along with wide brimmed hats whenever possible.A good sunscreen is the single most important factor in protection and treatment and should be worn whether indoors or outdoors.Those suffering from deep pigmentation should include Sunscreen in their daily skin care routine regardless of the time of year or their plans for outside activity.
Bleaching agents containing Hydroquinone (OTC strength 2%, RX strength 4%) and Kojic Acid should be used routinely.Both products lessen discoloration due to Melasma by way of resurfacing the outer layer of skin.
Plant glycosides and glucosamine hydrochloride (HCL) are available in over the counter products for those who are sensitive to hydroquinone. Exfoliation of the out layer of skin is essential in controlling hyper-pigmentation.
Products containing Azaleic Acid and Hydroquinone will inhibit the tyrosinase activity that is responsible for Melanin production in the skin, thus reducing the effects of Melasma.The addition of these products into a consistent skin care routine will show results over the long haul but many patients loose confidence when they do not experience “instant gratification”.
Vitamin A derivatives, glycolic acids (AHA), lactic and ascorbic acids will increase cellular turnover, thus minimizing the dark appearance.These products are available in topical solutions as well as chemical peels.
Stronger peels, resulting in varying down times, may help with Melasma affecting the surface layer of skin; however they have little affect if the pigmentation involves the deeper layers of tissue.
Results vary regardless of the methods of treatment.The most effective treatment for pigmentation deep within in the tissues is protection from sun and the passage of time.One day of sun exposure can undo months of treatment.Deeper pigmentations will fade away as times passes and products are used.The key to treatment for all types of Melasma is consistency and persistence.