I have Melasma around my cheeks and I'm considering a Chemical Peel for treatment. How safe is the procedure and what are the after effects? My age is 33 and have had the pigmentation since 2005. I have stopped taking oral contraceptives since January 2007.
Chemical Peel for Melasma on African Skin?
Doctor Answers 7
MelaPeel for African American Skin - Chemical Peel in Los Angeles
Raffy Karamanoukian, Los Angeles
Treating melasma in dark skin
Treating dark skin is more challenging, and melasma itself is a challenging condition to treat, and often unfortunately chronic. Best to hook up with a dermatologist who can review with you the best sunscreens and sun protection to use, to minimize and avoid triggers for melasma (e.g. oral contraceptive), and to advise you on combination therapy since chemical peels alone may not be sufficient for you. A home regimen that includes things like hydroquinone or retinoids is often worthwhile.
Laser for Melasma
It takes care, expertise and experience to achieve outstanding results with the resurfacing of skin of color. A foundation of a good daily skincare regimen is key this may include glycolic acids, topical antioxidants and hydroquinone, a lightening cream. Once the skin is properly pre-conditioned, certain TCA peel solutions are successful and we have found that our patients have been very pleased with the Artisan laser, a technologically more precise laser method that we prefer over peeling techniques. In addition there may be a vascular component to melasma, and for this we include treatment with a laser that addresses unwanted blood vessels and redness.
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Dark skin types with melasma must be peeled conservatively
Dark skin types with melasma must be peeled conservatively. Deeper peels may actually make things worse. I prefer a series of light combination peels, the compostion of which are customized for each patient.
Chemical peels are great choice for treatment of melasma in darkly pigmented skin
A series of superficial chemical peels would be a great adjunct for treatment of melasma in darkly pigmented skin. Focus on meticulous sun protection and get advice on the best regimen of OTC and prescription skin care products for your skin type from your dermatologist. Start this regimen before and continue during and after the peels. If the peels are too aggressive and you are not taking optimal care of your skin, the pigmentation could worsen.
Chemical peels in darker skin tones
Even more darkly complected individuals can have discolorations in part due to sun exposure. Melasma is a caused by a combination of hormones and sun in a genetically predisposed person. Sunscreen which covers both UVA and UVB must be a part of any treatment regimen for melasma even in African skin. In my experience, TCA peels work very well with all skin types. I would start with a 10% TCA peel and increase the concentration with each subsequent peel based on patient tolerance. I would recommend peels at monthly intervals. A 4% hydroquinone and a retinoid cream should be part of the home regimen.
Several Jessner's 14% or TCA 10% peels would probably be best for melasma
Jessner's solution peels or 10% TCA peels would do well for most blacks with melasma but usually you need 3-5 peels at 2 weeks apart at a cost of roughly $175-250 each followed by a good prescription cortisone lotion and sunscreen and bleaching cream.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.