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A disease of Hyperpigmentation
What is Melasma?
A skin discoloration, patchy hyper pigmentation occurring especially on con-vexes areas of the face like forehead, cheeks, chin, upper lip,,,
Who gets Melasma?
Women more than men, while in their reproductive age period, if existing hormonal imbalances, ethnic predisposition in Fitzpatrick skin type III,IV,V( darker tones of skin). It can occur during pregnancy in which case its termed "Cloasma". It is a "disease" of the very sensitive skin induced by exposure to SUN.
Are there stages of Melasma?
Melasma occurs in 2 stages epidermal and dermal-epidermal. Usually a period of time of 2 years or more of Melasma indicates a dermal spread of the melanocytes( the cells responsible for hyper pigmentation). While initially Melanocytes populate most of the epidermis( the superficial layer of the skin), with time melanocytes and their secretory granules filled with melanin migrate across skin layers deeper and deeper until they populate the papillary dermis.
Why is this important?
The deeper the location and spread of melanin cells the more difficult to treat Melasma as none of the topical medications and or lasers penetrate into the deep dermis( with few exceptions, but incomplete). Therefore treatment of Melasma can be challenging for most experienced Dermatologists.
What happens with sun exposure?
Melanocytes, the cells secreting melanin, which are very sensitive to sun BURST and release their melanin content into the surrounding skin layers resulting in hyper pigmentation.
Treatment options
- PREVENT FUTURE PIGMENTATION BY AVOIDING SUN EXPOSURE
- use UV protection at all times while outdoors( rain or shine)
- controlled exfoliation of the skin under direct medical supervision
- topical lightening creams under physician supervision
- laser treatment like photofacials, non ablative lasers, fractional lasers
The most consistent UV protection is provided against daily UVA rays by physical agents(vs chemical agents). During summer or when in sunny areas added UVB protection is a must.
Ascorbic Acid( Vitamin C) is a natural UVA protector of the skin. UVA RAYS damage collagen, cause wrinkling, loss of elasticity and pigmentation. UVA are 50 times more prevalent than UVB. UVB are stronger in the summer, cause sunburn and increase the risk of cancer.Dr. Kerns skin care line features SPF 45 sophisticated sun protector, specifically formulated
as an all-in-one sunscreen, foundation and under-eye concealer with 4% TITANIUM DIOXIDE. Available at Orchid Aesthetics Medical Spa.
Controlled exfoliation with medical grade peels and Retinoic acid products along with physician strength prescription lightening creams, are the main-stem of treatment for Melasma.
Dr. Kerns skin care line offers a great combination of Vitamin C cream or serum, HQRA( combination of hydroquinone, tretinol and hydro-cortisone) a prescription lightening cream scientifically proven to inhibit melaogenesis, limits melanosome transport, reduces photo-induced pigmentation.
Laser or light treatments ( photofacials) like BBL from Sciton address epidermal melasma and help the topical regimen to a faster resolution. A combination treatment is usually recommended for severe Melasma or after 3 months of physician supervised topical treatment.
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