Melasma

Before (above) and after (below) Cosmelan® Depigmentation Treatment.

What causes melasma?

UVA rays are a stimulant for melanin (brown pigmentation) to develop on the skin, and unfortunately can even penetrate through car window glass. For this reason the most important product to use everyday to help prevent melasma is a broad-spectrum sunscreen with Zinc Oxide and SPF 30+ to block the UVA rays. We recommend Skinfo® Pure Protection, which has the highest amount of Zinc Oxide available in sunscreens. Colorescience Sunforgettable® SPF30 powder sunscreen is also a must have to re-apply throughout the day, extremely light-weight and can be worn over makeup! Also wear a protective hat when outdoors for extended periods to further block these rays.

What is melasma?

Melasma is a skin condition that occurs on the face in the form of brown patches. A change in hormonal status (higher levels of estrogen) is thought to trigger and be the cause of the condition (i.e. birth control pills, pregnancy), although many women without these risk factors also develop melasma.

Are there different types of melasma?

There are four types of melasma, Epidermal, Dermal, mixed Epidermal-Dermal and Inapparent. The different types of melasma describe how deep the pigment is in the skin. Typically, the deeper the pigment the harder it is to treat. Epidermal melasma is the most common form and occasionally an exam can be done with a wood’s lamp to determine which type an individual has. However, melasma recalcitrant to therapy is most likely dermal melasma which can be better treated with a laser that can penetrate to the dermis (Fraxel Repair).

How can I treat melasma?

Fraxel Restore (aka Fraxel® SR1500) continues to be a great procedure for treating melasma. Most patients appreciate improvement after three monthly treatments. Very light settings are effective and therefore only result in about a day of redness following the treatment which is easily covered by makeup.

Another option, Cosmelan® Depigmentation Treatment, by mesoestetic®, is also highly effective for the treatment of melasma. A mask containing kojic, azeleic, salicylic and ascorbic acids is applied in the office. It is worn home and removed later that day after a pre-determined amount of time based on your Fitzpatrick skin type and skin sensitivity. An at home skin care program consisting of mesoestetic® Hydra-Vital Factor K cream and Cosmelan® 2 cream continues the treatment. The Cosmelan® Depigmentation Treatment Program is recommended no more than 2 times a year, at least 6 months apart. With each additional treatment, you should see incremental gains in the overall appearance of the skin. Subsequent treatments, after the initial treatment, will help to maintain the results achieved.

It is important to note that there is no procedure that will “cure” melasma. Therefore, at home use of skin care such as mesoestetic® Cosmelan 2 cream, glo-therapeutics glo-Lightening Serum or SkinCeuticals Phyto+ and diligent use of sun block with zinc oxide is always recommended to improve and prolong the results.

Most lightening products contain hydroquinone, a chemical which impairs the cells from making melanin, or botanical ingredients such as kojic acid, arbutin, and licorice. Visit Skinfo for a consultation to discuss which lighteners are best for your skin.

Is melasma curable?

Unfortunately melasma is not curable. It is important to always have appropriate sun protection on the skin every day (SPF 30 or greater with high percentage of zinc oxide) because the UVA rays cause the abnormal pigment to increase and darken. Even just one day without sun protection can cause melasma to worsen.

What does melasma look like?

Melasma appears as larger brown patches on the forehead, cheeks, nose and upper lip. It can occur in any one of these sites or a combination of these. In rare cases it may appear on the forearms or neck.

How can I find out more?

Schedule an appointment to discuss with a medical provider to determine what the best treatment plan may be for you.

Where did this information come from?

Dermatology online by Bolognia and eMedicine.com