Melasma

What is Melasma?

Melasma is brown discoloration on face, upper lip.

What is the cause of Melasma on face?

In this skin discoloration hormones play a major role. Combination of sun exposure, genetics and estrogen (pregnancy, oral contraceptives, hormone replacement, or your own hormones) causes discoloration to skin on the face. Most common in geographic areas with strong sun exposure, we often see patients with Melasma. Texas sun is strong.

Can I get rid of Melasma?

How to treat hyperpigmentation and response varies based on depth of pigment (deeper pigment is harder to remove) and whether causative factors can be reduced. After pregnancy it may fade. Often stubborn, there is always a tendency to reoccur especially with sun exposure.

How can I reduce the cause of Melasma?

Minimizing sun exposure is essential. Broad spectrum sunscreen with SPF greater than 30 with zinc oxide or titanium dioxide such as DCL Super Sheer Sunscreen SPF 50+ must be used daily, year round. Wear a hat and plan outdoor activities for morning or evening. Also helpful in reducing hyperpigmentation is mineral makeup with SPF.

What is the best Melasma treatment?

Melasma Treatment involves:

Reducing the cause of pigment production.
Inhibit production of melanin pigment with skin bleaches such as prescription HQ and botanical skin lighteners.
Increase skin penetration of skin lighteners and medications.
Remove pigment with exfoliants, retinoids and alpha hydroxy acids.
Calm pigment causing inflammation with antioxidants or surface steroids.
Strict daily sun protection with broad spectrum sunscreen with SPF of 30 or higher.
Cosmentic Medical Treatments such as Chemical Peels, SilkPeel® or microdermabrasion, Intense Pulsed Light (IPL®) or Fraxel® Laser Treatment are appropriate for certain patients.

Do skin bleaches work? I've heard about Tri Luma® (TriLuma®) cream for Malasma (Melasma).

With lighteners hyperpigmentation often improves. There are two types of skin bleaches or lighteners:

Hydroquinone(HQ) both over the counter and by prescription.
Effectiveness increases with increasing concentration, as does skin irritation.
There are three strengths of Hydroquinone:
2% HQ – over the counter (Porcelana®). Minimally effective.
4% HQ – prescription (Lustra®, Claripel®, Triluma®) cream for Melasma. Moderately helpful may cause irritation. Triluma® cream is combination HQ and topical steroid and only used for a limited time.
5-10% HQ – made by pharmacist; irritating with short expiration date.

Side effects of HQ skin bleaches: skin irritation, nail discoloration, temporary lightening of normal skin. If patients with very dark skin use HQs longer than 6 months, rarely permanent blue- black discoloration occurs. The FDA is evaluating continued approval of HQ because of safety testing concerns.

Natural Skin Lighteners include Bearberry Extract, Licorice Root, Niacinamide, Magnesium Ascorbyl Phosphate (Active Vitamin C), Chromabright™, Arbutin, Kojic Acid and Peptides.

Dr Elaine's® Antioxidant Skin Lightener was developed to help combat this frustrating problem without HQ. Natural skin lighteners Licorice Root, Bearberry and Niacinamide combined with antioxidant Green Tea even skin tone and reduce abnormal pigment. Melfade-J® (Magnesium Ascorbyl Phosphate--Active Vitamin C) and Chromabright™ brighten skin. Willow Bark exfoliates age spots. Aloe Vera soothes while Allantoin and Glycerin balance moisture without clogging pores.

Designed to take a 4 pronged approach: inhibit pigment production; calm inflammation; exfoliate damaged pigment; and broad spectrum sun protection, Dr Elaine's® offers four discounted Skin Lightening Sets:

Dr Elaine's® Skin Lightening Skin Care Set Normal, Dry, Combination Skin

Dr Elaine's® Skin Lightening Skin Care Set Normal, Oily, Combination Skin

Dr Elaine's® Basic Skin Lightening Skin Care Set Normal, Dry, Combination Skin

Dr Elaine's® Basic Skin Lightening Skin Care Set Normal, Oily, Combination Skin

Should I use anything else?

Retin-A®, Renova® or Tazorac® increase penetration of skin lighteners and shed pigment.

Dr Elaine's® Correcting Serum or Intensive Correcting Serum with Glycolic Acid, Willow Bark and Multi Fruit Acids Sugarcane, Lemon, Apple reduce discoloration, age spots and even skin tone. Antioxidant Green Tea fights pigment causing free radical damage.

Dr Elaine's® Antioxidant Enzyme Peel Papaya exfoliates pigment, antioxidant Grape Seed and Green Tea calms pigment.

DCL Super Sheer Sunscreen SPF 50+ broad spectrum sunscreen should be used every day regardless of skin type or planned sun exposure.

What about Chemical Peels for Melasma?

Glycolic Acid Chemical Peels remove the top layer of skin and reduce appearance of Melasma.

Does Microdermabrasion help Melasma?

SilkPeel® combines precision exfoliation with Kojic Acid for bleaching. In our Melasma treatment Texas clinic often best results are achieved by alternating SilkPeel® with Glycolic Acid Peels.