What's the best way to get rid of melasma? Can melasma ever be completely cured or will melasma treatment only reduce it?
Best Way to Get Rid of Melasma?
Doctor Answers 18
Treatment of melasma
1. Avoidance of hormonal agents (birth control, hormone replacement)
2. Sun protection
3. Temperature regulation: avoidance of heat triggers
4. Use of topical antioxidants
5. Lasers: Clear and Brilliant
6. Chemical Peels
Consult with a board certified Dermatologist to determine the appropriate treatment regimen for your individual case.
commonly induced by hormones (pregnancy, thyroid conditions)and exacerbated by UV exposure(sunlight, tanning beds), medication (birth control pills) and even heat. Understanding these as some of the various triggers for it are the most important tools you'll have in keeping it under control. A clinical skin care regimen that incorporates a series of chemical peels or a more aggressive TCA peel, such as the OBAGI Blue Peel has produced excellent results in reducing the appearance of pigmentation as a result of melasma. Home care that is inclusive of a lightener (i.e. hydroquinone)and sun protection(minimum SPF 30) are essential. Incorporating an antioxidant to serve as an additional layer of protection from the sun during the day and a retinol at night to aid in exfoliating dead surface skin cells will also be beneficial. Simply put, there is no cure, but definitely a condition that can be managed.
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Photoprotection is important
Melasma is primarily induced and exacerbated by sun exposure, and may be triggered by hormonal therapy such as oral contraceptive use or hormone replacement therapy, pregnancy, endocrinologic disorders, and dilantin therapy. First and foremost in any melasma treatment plan daily photoprotection is essential. Many times I find that the number one cause of melasma treatment failure is inconsistent use of photoprotection. Primarily I recommend patients use good sunscreen that has broadspectrum coverage (UVA/UVB) and at least SPF 30 (I prefer Elta MD) and wearing it daily even after clinical symptoms fade. In the office I typically evalaute the depth of pigment with a Wood's lamp, which can roughly estimate if pigment is in the upper layers of skin and will be amenable to topical therapy with hydroquinone and retinoids, or if it will require a deeper treatment with a chemical peel. Laser can be used as well. As melasma has a tendency to reoccur (particularly in darker skin tones) consistent use of a retinoid and photoprotection can help prevent flares.
Hydroquinone programs for melasma work best
We have heard from just about every single Melasma patient in our office that they have tried and failed a Hydroquinone treatment program. About 70% of these patients are happy to see after the treatments that they have improved dramatically using a different type of HQ program.
Over the counter and standard prescription strength hydroquinone treatments vary typically between 2% and 4% with 4% being prescription strength. The difference with the Celibre Medical program is that the HQ treatments we use vary between 6% and 14% (for the masks). Using higher doses can lead to much better results and more side effects, which is why we closely monitor our patients on a monthly basis and require that they only go on the program for 3 months consecutively. Because Melasma is a condition not cured but managed, our patients are on HQ for 3 months and off for 3 months. In between they use other products for depigmentation but without the HQ active ingredient.
We are currently performing trials using using the Hoya Conbio Medlite laser with high fluence (energy) high frequency treatments, but have not begun offering this to the general public. The protocols we are using for the trial are based on research from Asia, where Melasma is very prevalent.
Understanding the causes of melasma: Hydroquinone
Understanding the causes of melasma is the most important step in treating the condition. Melasma is characterized by excessive deposition of pigment in the skin, usually the face.
The causes include:
- Hormones: Estrogen and progesterone work on cell receptors on melanocytes to stimulate the production of melanin. Hormones can increase as a result of birth control pills, estrogen replacement, phytoestrogens, and pregnancy.
- Sun Exposure
- Active inflammation of the skin from skin diseases or acne
Once you control the cause, there are many options including Hydroquinone topical cream, chemical peels, IPL, lasers including Fraxel.
The primary focus of treatment is that there is no cure for melasma, but rather, only treatments. It is a lifelong process that will have to continue as long as the causes continue.
No Short -Cuts for Treating Melasma
Melasma is a common disorder that is often difficult to treat. It isn't unusual for a patient to become frustrated after trying a variety of treatments in an attempt to obtain satisfactory results. Like most other complicated skin conditions, a combination of treatments paired with the proper skin regimen works best! Topical de-pigmenting agents such as hydroquinone or other melanin inhibitors along with a topical tretinoic acid to increase skin cell turnover, hastens the fading of uneven patches. This commitment along with specific medical-grade chemical peels, appropriate laser treatments and diligent protection , can enhance the likelihood of reducing or resolving melasma !
#melasma #chemicalpeels # unevenskincolor
Dermamelan works most consistently in my opinion for Melasma
In the UK, where the sun doesn't shine that often (!), i find that the most consistent treatment is Dermamelan. We really don't have to combine it with other treatments either. You need to be prepared for a week or so of peeling but the results are definitely worth it. You need to maintain your skin on the dermamelan cream for 6 months and then ensure good sun protection. As soon as you see signs of it coming back you can go back on to the cream or reapply the mask. But you should always have your skin supervised by a practitioner.
Treating Melasma effectively.
Cosmelan and Chemical Peels are the best way to remove Melasma
Although every patient will respond slightly differently to various treatments, I have
found in-office treatment with Cosmelan® to be consistently effective at reducing
the signs of melasma, followed by at-home treatments with nourishing skin
creams that contain kojic acid, azelaic Acid, and Vitamin K and then a second,
shorter application of Cosmelan. I would avoid lasers such as Fraxel since I find that they have a higher recurrence rate and can make the skin more susceptible to the sun. Once I remove melasma with the various peels or bleaching creams, strict sun avoidance is essential in preventing melasma from returning. Common contributors to melasma include birth control pills, pregnancy and sun exposure. Please consult a board certified dermatologist who is an expert in Melasma for the best cosmetic treatment. Best, Dr. Green