To understand melasma we need to understand what hyperpigmentation is and how it starts.
Hyperpigmentation is a deposition of melanin (pigment) due to the stimulation of melanogenesis. Melanogeneis is the process by which pigment is produced then duplicated in the skin. It is the end result of the immune system triggering an inflammatory response, which then triggers melanocyte activity to protect the skins DNA from damage and mutation. This process is started by any hormonal trigger (melasma’s most common trigger) or cutaneous inflammation such as heat, trauma, and sun.
So what is Melasma?
Melasma is a pigmentation disorder that causes dark patches on the face. This is triggered by fluctuation of hormones ( pregnancy, oral contraceptives, thyroid disfunction, menopause, or hormone replacement therapy). They normally appear symmetrically (both sides) on the face, you usually have it across the forehead, cheeks, across the lip area and chin area. This pigment also worsens with UV exposure. This pigmentation is harder to treat but with the right products you can help lessen the appearance of your pigmentation.
Women with darker complexions and who are pregnant are at greater risk of developing melasma.
For other people, melasma can last for years or even for the rest of their lives. If melasma does not fade over time, a person can seek treatment to help lighten or fade the patches.
However, most of the time melasma is something that you control and lighten and can not get rid of completely. It is worth it to help lighten the pigmentation especially if its something that is bothersome to you.
How to control you melasma:
Gently Exfoliate- using gentle peeling agents that do not cause undue trauma to the skin.
Increasing cell turnover- Vitamin A/retinols help to increase cellular turnover , bringing healthy cells to the surface more quickly.
Inhibit Melanogenesis- in attempt to discourage melanin, we recommend using melanogensis inhibitors in daily care products and professional treatments. It is wise to use a product daily that contains gentle melanogensis inhibitors to stave off any future discoloration, even after success has been achieved it is important to continue using these type of products.
Protect from UV rays and inflammatory stimulants: This is particularly important for those trying to rid themselves of hyperpigmentation. If the skin is exposed to UV rays on a daily basis (even walking to and from your car or exposure from fluorescent light bulbs) the process of evening out the skin tone will be slowed and some cases halted. We highly recommend physical based sunscreens, which contain zinc oxide or titanium dioxide and can sometimes be combined with chemical sunscreens
Zinc Oxide is the only active sunscreen ingredient that provides full spectrum coverage of UVB and long and short UVA rays by itself.
Titanium Dioxide is the next best ingredient that covers both UVA and UVB, although it does not cover long UVA rays.
Chemical Sunscreens are limited in their protection and need to be combined in order to accomplish what Zinc Oxide can do alone.
Treatments that help in conjunction with products are, chemical peels, micro dermabrasion and microchannelling, we do not recommend laser treatments for melasma as this can cause the pigment to come back even darker than before. Laser treatments are best for hyperpigmenation from normal sun damage.
It is KEY that you are on a good skincare regimen when trying to treat your melasma. You will get more results than just trying treatments alone.
Here is a regimen that includes what we listed above in How to Control your Melasma.
This regimen has been very helpful for our clients.
Ormedic Cleanser alternate with Total Ageless Cleanser or Mandelic Wash. You can also just use Mandelic Wash daily.
Total Ageless Serum
Iluma Intense Brightening Serum,
Prevention Ultimate SPF 50, Matte SPF, or Tinted SPF, or TIZO (primer and tinted) these all have physical sunscreens in it
Ormedic Cleanser alternate with Total Ageless Cleanser or Mandelic Wash
Iluma Bleaching Serum (use for 3 month on 3 months off, when not using, use Iluma Brightening Serum twice a day)
Face Reality Vitamin A Serum or Image Skincare Total-A Creme
Iluma Brightening Cream
This protocol with consistent use will get you closer to a more even skin tone.
You can also set up a skincare consultation on our booking site by clicking here or by contacting us at firstname.lastname@example.org
Sources: Physicians Care Alliance Text Book pg: 39-43