Melasma is a very difficult and frustrating condition for both the clinician and the patient. Over 6 million Americans suffer from this condition and roughly half of this number does not know what causes it or how to treat it. Surprisingly, 10% of men can also develop melasma.
There are still a lot of mysteries surrounding this condition and why hormonal fluctuations trigger the melanogenesis response. These hormonal fluctuations can be brought on by pregnancy, birth control, hormone-replacement therapy, or thyroid or hormonal disorders. In addition, melasma can be exacerbated by internal heat, inflammation and UV rays. Melasma is typically seen more in Fitzpatrick skin types IV and V, but anyone can be affected by it.
A broad-spectrum SPF product must be used every day, when treating melasma, and this must be conveyed to the patient during the first consultation. Without SPF, products and professional treatments will not produce the desired results. Daily care product use is also important in controlling the pigmentation process at home. Look for ingredients that inhibit pigment, such as hydroquinone, azelaic acid, kojic acid and licorice root extract, to name a few; and ingredients that provide antioxidant and anti-inflammatory protection.
Treating the skin with gentle chemical peels every three weeks is the recommended professional treatment for melasma patients. By treating the skin every 21 days, the clinician is able to prevent pigment that is rising to the surface of the skin from appearing darker, and this type of consistent exfoliation will lead to quicker lifting of the pigment without causing undue inflammation.
It is recommended to avoid overly-aggressive treatments, such as straight TCA peels, high percentages of hydroquinone or light therapies, such as laser or IPL. Patients commonly request IPL or laser as they think these will provide instant gratification and removal of their melasma. In fact, these are no longer recommended for melasma: IPL is considered an inconsistent treatment with only a small number of patients responding favorably; and laser treatments are too unpredictable and may produce initial lightening followed by a reoccurrence or worsening of the discoloration.
PCA SKIN® provides gentle professional treatments for melasma, as well as daily care options for all sky types. Remember: the key to treating melasma successfully is to understand its triggers and to inform your patients of the best treatments for their unique skin type, product use and lifestyle changes that will improve the health and appearance of their skin.