What is Melasma and what are the treatment options?
Melasma, also known as chloasma, is a complex form of pigmentation that is often stimulated by sun exposure and oestrogen – either from pregnancy, the contraceptive pill, hormone replacement therapy or normal circulating oestrogens. As a result, melasma mostly affects women, although it can occur uncommonly in men. It appears as large brown-grey patches on the face. It is usually located on the cheeks, upper lip, between the brows, or on the forehead.
Often the affected areas look worse in summer months as exposure to ultraviolet radiation (UVR) deepens the pigmentation because it activates the melanocytes to produce more melanin.
One of the most common treatments for melasma is sun avoidance. This includes wearing wide brimmed hats, sunscreen every day and avoiding direct sun onto affected areas. Avoiding synthetic hormone treatments is also recommended.
There are depigmenting/bleaching creams that are often used as treatment and or prior to use of laser treatments. Common ingredients we use in our topical formulas are Hydroxyquinone 4% as this inhibits Tyrosinase, an enzyme involved in the production of melanin. Usually this is combined with other ingredients such as kojic and retinoic acid.
The Fraxel laser is used for the treatment of melasma. It has FDA (Food and Drug Administration) approval for the treatment of melasma in the US. Fraxel laser only treats a fraction of the skin by firing micro-columns of laser energy into the skin. The fractional nature of the laser allows the unwanted pigmentation to break down and extruded from the skin. Usually 3 treatments are required over a period of time. Despite any treatment, there is still a chance of recurrence of the pigmentation.