Melasma

Melasma is blotchy areas of skin pigmentation on the face

Melasma, also known as chloasma, is blotchy areas of skin pigmentation on the face, especially forehead, cheek and upper lip. It is more common on darker skin types. It is especially common in women aged 20-40 and is associated with pregnancy or taking the contraceptive pill or injection. It also happens in healthy, non pregnant woman taking no medications and men using aftershave.

Sun exposure following some cosmetics can cause a phototoxic reaction where the chemical substance absorbs UV light. The resulting pigmentation extends where sun and cosmetic use have coincided, for example down the neck, often more on the right side in countries that drive on the left.

Melasma is more stubborn to treat than freckles or age spots because the melanocytes have become sensitized and continue to produce extra pigment with even the slightest hint of sun. Sun protection is an essential part of treatment.

Consider stopping hormonal medications although it may be many months before any benefit from this becomes apparent. Fading creams containing hydroquinone, alpha-hydroxy acids, retinoids or Vitamin C inhibit new pigment formation. Lasers and chemical peels can reduce existing pigmentation but should be used carefully as skin with melasma is more prone to postinflammatory hyperpigmentation. Cosmetic camouflage using special make up is another approach.

Palm Clinic has the best available laser for treating melasma, the Fraxel Dual laser. This is a revolutionary new laser which improves melasma by fractional resurfacing of the skin. This decreases the melanocyte population so less melanin is produced. Fraxel is the first laser to be approved by the American FDA for melasma and can be used on Asian, Polynesian, Maori and European skin.

The Photoderm IPL and Elos Aurora lasers can temporarily fade melasma. Ongoing treatment with fading cream is essential to preserve improvement.

We recommend our melasma patients to use a special melasma cream which combines hydroquinone, kojic acid and tretinoin which is available at Palm Clinic.