Melasma shows up as brown spots or splotches on the forehead, cheeks, jaw line or upper lip. Melasma is essentially too much dark pigment. That pigment has been triggered by hormones and/or sun. Melasma can appear when a woman’s hormones change, whether through pregnancy, oral contraceptives, or hormone replacement therapy after menopause. Women of color are prone to melasma, and it is a significant problem for many. But people of any skin type can get melasma.
Once melasma has gotten started, for example during a pregnancy, it may become very difficult to treat afterwards. Also, it tends to become worse with subsequent pregnancies, particularly if the pregnancy is during the summer. If you do get melasma during the pregnancy, chances are it will resolve after delivery. But in a small percentage of women it gets worse over time and with exposure to sunlight.
To Treat Melasma
If you have melasma from hormones or prior pregnancies, please seek advice from your dermatologist first. Melasma can be difficult to treat.
(a) Sun block and Sun Protection
This is the most essential part of any treatment regimen for melasma, every single day, even cloudy days & indoors. The use of a broad spectrum sun screen that contains a physical blocking agent for example zinc or titanium dioxide.
(b) Double Protect – Wear Sun Protective Clothing
If your melasma is bad, wear long-sleeved shirts and pants and wide-brimmed hats.
(c) Stay out of the sun in the mid-day
(d) Topical Products
Because melasma is a disorder of pigmentation, topical products that block the process of pigment production are helpful in the treatment of melasma. Pigment production is a complex process and there are many products that act at different steps in this process. No one product is 100% successful at preventing and treating pigment so often multiple different products are used as they all work at different steps in the process.
Hydroquinone (HQ) is thought to improve pigment by inhibition of tryosinase, an enzyme critical for pigment production. It has been in use for over 50 years and has a long and well documented history of safety and efficacy in the treatment of pigment.
Retinoic acid and its derivatives (Retin-A, tretinoin, retinol, adapalene, tazaratene) have been shown to reduce the pigment of melasma and sun damage. They act by stimulating skin cell or keratinocyte turnover, decreasing transfer of pigment to skin cells and enhancing penetration of other active ingredients. Additionally, retinoids are an essential part of an anti-aging skin care regimen as they act to block the breakdown of collagen in the skin upon sun exposure.
(g) Ascorbic Acid or Vitamin C
In addition to being a powerful antioxidant, Vitamin C in skin serums and creams can block copper where it interacts with tyrosinase. Antioxidants are a critical part of any anti-aging program as they prevent oxidative injury to the skin with sun exposure.
(h) Topical agents
Licorice extract, soy, resveratrol, bearberry extract, emblica extract.
(i) Trichloroacetic acid (TCA) peels
Dermatologists have been using TCA peels, a close cousin to vinegar, to do chemical peeling for at least twenty years. Some dermatologists, in fact, still prefer TCA peels to any other modality for treating melasma, usually in combination with prescription creams. TCA peels are excellent and safe in the hands of an experienced dermatologist. This is a good option, particularly if you have severe melasma. Such procedure should only be performed by certified doctors.
– Effective, safe & FDA approved. You may contact Rachel Chew Clinic to enquire more.