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Identifying Melasma, What Stands Behind Those Brown Spots?

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Identifying Melasma, What Stands Behind Those Brown Spots?

Identifying Melasma, What Stands Behind Those Brown Spots?

Article Highlights

  • Melasma is a skin condition consisting of dark patches mainly on the face, typically on the forehead, cheeks, nose and upper lip, but occurring on the neck, chest and arms as well
  • [Hydroquinone] inhibits tyrosinase, an enzyme that produces melanin, but can be irritating
  • Clear + Brilliant Perméa laser is a mild, non-ablative laser that creates micro channels in the surface of the skin to allow passage of various products into the skin

Everyone seems to know everything about harmful ultraviolet rays—or just enough to remember to apply sunscreen every now and then. Still, only a few of us wear sun protection year-round, and even fewer protect their faces with a wide-brimmed hat in the summer months.

Dermatologists worldwide can’t emphasize enough the importance of proper sun protection, warning us about the risks of skin cancer with other potential sun-caused skin conditions we ignore, like sunburns, which are often mistakenly considered an indispensable part of a successful vacation. One particularly ignored outcome is associated with brown spots, which can be a sign of melasma.

“Melasma is a skin condition consisting of dark patches mainly on the face, typically on the forehead, cheeks, nose and upper lip, but occurring on the neck, chest and arms as well,” said Dr. Martie S. Gidon, a dermatologist at Gidon Aesthetics and MediSpa. “It is caused by an increased production of melanin and any skin type can develop it.”

Melasma gradually darkens over time and is caused by prolonged sun exposure over many years. Though it occurs more commonly in women between the ages of 25-55, men can develop it as well. The causes of this skin condition can range across the board, with sun exposure being one of them. You may also be at risk if there is a family history of it, if you experience hormonal changes, or if you use oral contraceptive pills. Also, take a closer look at your skin care products, as they may irritate your skin and worsen the state of melasma.

Consult your dermatologist if you are unsure of what may be a sign of this condition. They will be able to diagnose it by inspecting your skin or checking it under a Wood’s lamp to determine whether it is superficial, deep or a combination of both. Treatment always depends on the severity of pigmentation: the deeper it is, the harder it is to deal with.

Topical Treatments

Most patients usually require a combination of procedures, but proper sun protection is crucial. Dr. Gidon recommends sunscreens with SPF 50+ containing zinc dioxide and titanium dioxide for protection against both UVA and UVB rays. With severe cases of melasma, Dr. Gidon usually suggests her patients use hydroquinone as the most powerful fading ingredient.

“[Hydroquinone] inhibits tyrosinase, an enzyme that produces melanin, but can be irritating,” Dr. Gidon explained. “People using hydroquinone should be followed by a dermatologist, since prolonged usage can rarely result in additional darkening of the skin.”

Generally, hydroquinone is prescribed in combination with kojic acid, tretinoin, vitamin C and a mild cortisone cream. Non-aggressive fading remedies may include glycolic acid, rumex crispus, green tea, soy and licorice. According to Dr. Gidon, pregnant women should not be treated for melasma with topical medications, as they may be harmful to the fetus.

Microdermabrasion And Peels

It is possible to stop melanin production and eliminate melasma by using SilkPeel® Microdermabrasion with dermal infusion of Lumixyl. With no downtime, a series of six treatments, two weeks apart, are necessary for the best results.

Dr. Gidon elaborated that chemical peels have proven to be another effective remedy in fighting melasma. Peels that include light glycolic acid have a non-aggressive peeling and fading effect, with results usually achieved after six treatments, two weeks apart. The side effects? The procedure may cause slight pinkness, which will disappear in a few hours or days.

Radiance peel is another treatment Dr. Gidon offers to her patients. This fading mask with hydroquinone, vitamin A acid, fruity acids and plant extracts is applied at the clinic and should be removed at home after nine hours. This procedure may cause temporary pinkness and peeling for about one week.

Laser Treatments

According to Dr. Gidon, the Clear + Brilliant Perméa laser treatment can help fade melasma after five treatments, two to four weeks apart.

“Clear + Brilliant Perméa laser is a mild, non-ablative laser that creates micro channels in the surface of the skin to allow passage of various products into the skin,” Dr. Gidon said. “Lightening ingredients can penetrate more effectively, pigmented cells are sloughed away resulting in lightening of the skin.”

There may be minor side effects, including temporary pinkness and skin puffiness. Fraxel laser treatments may be another option in treating melasma. According to Dr. Gidon, this non-ablative laser produces microscopic sites of heat in the skin, which are then eliminated together with pigmentation, stimulating the production of non-pigmented cells. Dr. Gidon usually recommends three procedures, taken six to eight weeks apart.

“Melasma is a skin condition consisting of dark patches mainly on the face, typically on the forehead, cheeks, nose and upper lip, but occurring on the neck, chest and arms as well,” said Dr. Martie S. Gidon.

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