Melasma
Melasma is a skin condition characterised by blotchy pigmentation occurring in a somewhat symmetrical fashion on the face. Common areas include the forehead, upper lip and upper cheeks.
It is primarily found in adult women between the ages of 20 and 40 but can affect men as well. Melasma often darkens in summer and lightens in the winter and is made worse by heat. Melasma can affect self confidence and be debilitating for some.
Melasma is caused mainly by hormonal factors, frequently onset by pregnancy, the contraceptive pill or those with polycystic ovaries (PCOS). It is further enhanced by sun exposure.
Melasma primarily presents as patches of lighter or darker brown pigmentation, usually to the cheeks, forehead and upper lip of affected individuals. Due to its high occurrence in pregnant women, it has been referred to as the mask of pregnancy.
Melasma is generally classified according to where the pigment is located in this skin; more superficially in the epidermis, deeper in the dermis, or a combination of both. Those with deeper dermal pigmentation are much more difficult to treat. We see and treat a combination of epidermal and dermal melasma at Youth Lab and can recommend treatments suitable for both.
FAQs
What causes Melasma?
Melasma occurs due to excessive stimulation of melanocytes which produce excess amounts of melanin (brown colour) within the skin.
The known causes are:
Gender
Melasma is more common in women, primarily between the ages of 20 and 40.
Hormones
Melasma often peaks during pregnancy and is often due to hormonal imbalances such as Polycystic Ovaries and those who take medications containing oestrogen such as the combined contraceptive pill (oestrogen stimulates the production of melanin).
Genetics
There is a known genetic link.
Skin type
The condition is often worse in darker skin types such as those of middle eastern, Indian and Asian descent.
Sun exposure
Melasma is triggered and made worse by exposure to UV light.
How is Melasma managed?
Melasma is a chronic condition and many of those who suffer from it may feel they have tried everything. It is very important to note that there is no cure and treatment is aimed to control the condition, suppress the pigmentation and reduce the appearance of hyperpigmentation.
The treatment is known to relapse, especially if the triggers are not treated and the condition may wax and wane in severity over a number of years. Patience and commitment to a treatment regime is essential to control the condition.
Those with superficial melasma (pigment in the epidermis) are more likely to respond to treatment and the earlier treatment is initiated the better as this can delay the onset of deeper pigmentation which is more difficult to treat.
Individual patient factors must be considered including patient objectives, risk of downtime and severity of the condition. It is important to treat Melasma carefully and effectively as disturbing the basal layer of the skin can risk further pigmentation. Pigment will always return with continued UV exposure.
How do we treat Melasma at Youth Lab?
The most important part of treatment is to remove any exposure to triggers. This includes strict sun protection and daily use of a broad spectrum SPF. Any sun exposure will trigger and stimulate the melanocytes and exacerbate the condition.
We may ask clients to consider discontinuing use of hormonal treatments such as the contraceptive pill and treat any underlying hormonal problems such as PCOS (under medical supervision).
Once triggers are controlled topical treatment is needed which aims to slow down melanin production and reduce the appearance of pigment.
These include prescribed creams as well as cosmeceutical brightening and lightening creams containing ingredients such as Hydroquinone, retinol, kojic and azelaic acid. A doctor’s consultation may be required if prescription creams are needed for more severe cases.
In-clinic treatments, when combined with trigger avoidance and home care, will optimise outcomes and improve symptoms of melasma.
These treatments are aimed at lightening existing hyperpigmentation, removing deeper pigment, exfoliating the skin, allowing increased penetration of skin care ingredients and suppressing further melanin production.
Regardless of the treatment regime it is important to note that ongoing treatments will be needed and continuous home care and sun avoidance is essential to suppress the pigmentation. Treatments are aimed to maintain and control the condition.
What are our recommended treatments?
As with many of the treatment recommendations at Youth Lab, a combination of treatments may be required for optimal results.
Please note that the below recommended treatments is a reference point and full treatment recommendations will be made following a consultation.
Dermamelan
Dermamelan is the gold standard topical treatment for melasma and pigmentation. It is a mask application containing active ingredients which work to suppress melanin production, reduce the appearance of melanin and prevent recurrence of pigmentation.
Clinical Peels
For melasma unresponsive to topical treatments and to combine treatments for maximal results chemical peels are a safe and effective option. Chemical peels cause exfoliation of the superficial to mid layers of the skin. This treatment is most effective for epidermal melasma.
Halo Laser
Laser is reserved for severe cases and when used incorrectly and without adequate skin preparation (such as use of a topical melasma treatment) can make melasma significantly worse. It is best used in cases of superficial melasma where the pigment sits in the top layers of skin rather than deep pigmentation.
Skin Needling
Skin needling with brightening and pigment inhibiting serum infusions can help with superficial pigmentation due to hormonal melasma without inducing an inflammatory response.
