What is Melasma?

Melasma is brown or grayish discoloration on face, upper lip.

What is the cause of Melasma on face?

In this type of skin discoloration, hormones play a major role. In combination with sun exposure, genetics-- estrogen – either pregnancy, oral contraceptives, hormone replacement therapy, or a woman’s own hormones causes discoloration to the skin on the face. It is more common in areas with strong sun exposure. We frequently see patients with Melasma. Texas sun is quite strong.

Can I get rid of Melasma?

How to treat hyperpigmentation and the response varies based on the depth of the pigment (deeper pigment is harder to remove) and to what degree factors causing it can be reduced. For pregnant women, it may fade after delivery. Some cases are very stubborn. There is always a tendency for it to reoccur.

How can I reduce the cause of Melasma?

Minimizing sun exposure is essential. Broad spectrum sunscreen with an SPF greater than 15 with zinc oxide or titanium dioxide such as Dr Elaine's® Protecting Sunscreen SPF 20 to block light must be used daily, year round, and reapplied every 2 hours during sun exposure. Hats should be worn and outdoor activities planned for morning and evening. Helpful in reducing hyperpigmentation, makeup with a high SPF such as mineral makeup is used.

What is the best Melasma treatment?

Reducing the activity of the pigment cells with skin bleaches, and removing pigment and increasing the penetration of medications with Chemical Peels and SilkPeel®, and reducing hyperpigmentation with Intense Pulsed Light (IPL®) or Fraxel® Laser Treatment.

Do skin bleaches work? I have heard about Tri Luma® (TriLuma®) cream for Malasma (Melasma).

With use of lighteners hyperpigmentation often improves. There are several types. Hydroquinone(HQ) has been used for many years and is found in both over the counter and prescription forms.
The effectiveness increases with increasing concentration, but so does skin irritation.
There are three strengths of Hydroquinone:
2% HQ – over the counter such as Porcelana®. Minimally effective.
4% HQ – prescription Lustra®, Claripel®, Glyquin®, Solaquin®, Triluma® cream for Melasma. Moderately helpful and well tolerated.
5-10% HQ – made by pharmacist. Is irritating with a short expiration date.

Side effects of skin bleaches: skin irritation, nail discoloration, temporary lightening of normal skin. If patients with very dark skin use HQs longer than 6 months, a rare possibility of a permanent blue-black discoloration.

Other skin lighteners include Bearberry Extract, Arbutin, Licorice Root, Vitamin C and Kojic Acid. Many of our patients effectively use our Dr Elaine's® Total Eye Renewal containing Magnesium Ascorbyl Phosphate (Active Vitamin C) and Bearberry Extract on their Melasma.

Should I use anything else?

Prescription Retin-A®, Renova® or Tazorac® to increase penetration of skin lighteners and to shed some of the pigment through peeling.

Dr Elaine's® Perfecting Lotion 10% SPF 15 contains glycolic acid 10% to help eliminate pigment, and a broad spectrum sunscreen. It should be used every day regardless of skin type or planned sun exposure.

What about chemical peels for Melasma?

Glycolic Acid Chemical Peels remove the top layer of skin and reduce appearance of Melasma.

Does microdermabrasion help Melasma?

SilkPeel® combines precision exfoliation with Kojic Acid for bleaching. In our Melasma treatment Texas clinic often best results are achieved by alternating with glycolic acid peels.

Do light treatments help Melasma?

Intense Pulsed Light (IPL®) uses specific wavelengths of light to treat pigment and can help some forms of Melasma.

We often use GentleWaves® LED light treatment after Chemical Peel or SilkPeel® to give additional pigment calming results.

Does Fraxel® Laser help Melasma?

Fraxel® Laser Treatment affects only a fraction of the skin at a time with thousands of tiny laser spots and may be used to help eliminate pigment.