What is Melasma?
Melasma is a common pigmentation condition that is caused by an over production of tyrosinase which over-stimulates the melanocytes of the skin. Once melanocytes are over stimulated, they start producing more pigmentation. Melasma is much more common in women than men and is more common in people with darker skin. Melasma appears most commonly on the face as brownish patches and is worsened by unprotected exposure to the sun as well as exposure to heat.
While it can occur anywhere on the face, common areas include the forehead, cheeks and upper lip (often appearing as a “moustache”). It is critically important to keep the skin protected by appropriate sunscreen and by the use of a hat, if at all possible. Melasma can also be triggered or worsened by hormones, particularly in women, and is commonly seen in pregnant women, giving it the name “pregnancy mask”. It can also be triggered by the use of some medications, such as birth control pills.
While in some cases melasma may initially fade on its own, in a lot of cases it eventually becomes permanent over time and can often fluctuate in intensity. There is no cure for melasma, and the pigmentation associated with melasma can return even when effectively treated, especially if the patient is not careful with their sun exposure. Fortunately, for individuals who are bothered by their melasma, there are several effective treatments available to minimize the condition.
At Art of SKIN Dermatology, Laser and Cosmetic Surgery, treatment options for melasma include:
- TCA chemical peels
- Topical skin lightening products (Obagi Nu Derm protocol)
- Laser therapy
TCA Chemical Peel
How Does a Chemical Peel Work?
The most effective treatment available for melasma is through the use of a chemical peel. Chemical peels work by removing the outer layer of skin (containing the excess pigment) to reveal the newer, pigment-free skin below the surface.
In a TCA chemical peel, a solution of trichloroacetic acid (TCA) is applied to the face to remove the outer surface layers of the skin, revealing the newer skin beneath and safely reducing the melasma – associated pigmentation.
TCA chemical peels not only will reduce the pigmentation associated with your melasma, but will also remove superficial skin irregularities, including sun damaged skin cells and precancerous skin lesions. Results include:
- More uniform skin colour
- Smoother skin texture
- Less damaged skin cells
- Overall healthier skin
- Less wrinkles
In many cases a single peel will be sufficient to adequately remove the pigmentation. However, in some cases, more than one peel treatment will be required, especially if milder peels are used.
After treatment, the patient will be educated on an appropriate skin care regimen, including diligent use of sun protection to help keep the pigmentation from reforming. TCA chemical peels can be safely repeated on an on-going basis (ie every few years) if necessary.
At Art of SKIN Dermatology, Laser and Cosmetic Surgery, we offer TCA chemical peels in varying concentrations as an effective and safe treatment option for melasma.
Obagi Nu Derm Protocol
The Obagi Nu Derm protocol is a topical skin care product line that can be very effective in treating melasma. Melasma is caused by an over production of tyrosinase, which results in increased pigmentation. The Obagi protocol essentially filters the amount of tyrosinase that reaches the melanocytes, therefore, effectively allowing them to produce a normal amount of pigmentation. As the skin cells rejuvenate, the discolored cells come up to the surface and are shed naturally, revealing brighter, normalized skin.
While the Obagi protocol can be effectively used on its own in milder cases. For more advanced or established cases of melasma, the Obagi protocol works best as a maintenance treatment after the patient has successfully had a TCA Chemical peel.
There is no cure for melasma at this time. It can be improved considerably, but it is a skin condition that must be controlled by active skincare and sun protection.
It is important that the proper diagnosis first be determined prior to treatment. A dermatologist is the most qualified skin professional to assess your pigmentation condition and to educate you on the different treatment options.
If you are bothered by your melasma, call Art of SKIN Dermatology, Laser and Cosmetic Surgery and book a consultation. We can design a treatment plan to help reduce your pigmentation and help you to feel more comfortable with your skin’s appearance.