Melasma refers to patchy hyperpigmentation usually on both cheeks, the bridge of the nose, the chin, the upper lip and even the forehead. Less commonly, melasma can also occur on the body such as the neck or the arms (sun-exposed areas). This pattern of hyperpigmentation is related to sun exposure and is also hormonal-related, meaning it is commonly seen in pregnancy and hormonal therapies (such as the oral contraceptive). Those who have it will know the melasma is notoriously difficult to treat, because it is difficult to remove the instigating hormonal factors. In this article, SKIN gathers the top doctor-approved treatments for melasma.
STEP #1 STAY OUT OF THE SUN
Melasma is often worse in summer and improves in winter. Ultraviolet (UV) light exposure from the sun stimulates pigment cells in the skin (melanocyes) which produces too much pigment. Avoid being out in the sun deliberately, and if you are exposed, ensure you wear protective clothing such as a wide-brimmed hat and apply a good sunscreen.
STEP #2 USE A LIGHTENING CREAM
Apply a skin lightener that contains lightening agents such as hydroquinone, kojic acid and an exfoliating agent such as retinol or glycolic acid. Some people are worried about hydroquinone causing a bluish-black tint on the skin and use products that contain mequinol instead, another prescription alternative to hydroquinone that is as effective but without the risks of discolouration.
STEP #3 PICOSECOND LASERS – GENTLY DOES IT
More often than not, melasma is mixed – the pigments are both epidermal (superficial) and dermal (deeper). Conventional photo and laser therapy have been shown to be effective for melasma but there is a risk of causing the pigmentation to darken or spread when there is too much heat. The American Society for Dermatologic Surgery meeting discussed the efficacy of using picosecond lasers to treat melasma, and found that the picosecond laser therapy minimizes this risk. This novel laser does so by delivering laser energy much more rapidly than the traditional nanosecond laser, resulting in a photoacoustic effect and shattering the pigments which are then naturally removed by the body.
STEP #4 BB AQUATOUCH – REVEAL NEW SKIN
The BB Aquatouch is a fractionated non-ablative thulium laser in the 1,927 nm wavelength which targets epidermal pigment more efficiently, and the improvements are often noticed after just one treatment! Targeting water molecules in the skin, this laser treatment remodels the dermal-epidermal junction, which is thought to be abnormal in melasma, and deeper dermal melanin is “shuttled” out and then exfoliated. Another well-loved point – a thulium laser brightens the skin and gives a dewy effect within a week or less.