Move Over, Melasma!

 

                Different skin conditions can be difficult to diagnose, and sometimes even more so to treat. Melasma (chloasma) is one of the more complex conditions that affects many patients leaving them frustrated and struggling for answers. Melasma is different than sun damage and hyperpigmentation because of its unique mechanism of action-it is stimulated by hormonal fluctuations. Unlike UV-induced pigment, melasma has some key characteristics that can make it easier to identify. Having a better understanding on this tricky condition can help you to better control your symptoms. 

What does melasma look like? Unlike a diffuse distribution of hyperpigmentation (like you commonly see in sun-damaged patients), melasma has a patchy distribution with a distinct line of demarcation. These brown, or sometimes grayish/brown patches will most likely be present in the face, cheeks, chest, forehead, nose, and chin areas. 

 (photo: American Academy of Dermatology)

“My melasma seems to get worse in the summer, and better in the winter” This observation is commonly seen with this condition. Sun exposure can make the hormonal spots appear darker, and heat exposure can have the same effect. Unfortunately, any time a patient experiences any type of internal heat (even working out, and hot yoga), the pigment can become worse.

What can I do to treat my melasma? Treatment for melasma includes reducing stimulating factors (sun + heat exposure) when possible, and following a strong home-care regimen. Unlike other sun damage, deep chemical peels and lasers can actually cause more harm to melasma patients because of the stimulation of heat. Gaining control of your hormones can also be difficult because typically eliminating pregnancy, birth control, and breastfeeding are not desired options, or preferences.

What products should I use at home? Patients will see a huge benefit from a few powerhouse pigment products: Vitamin C + E (to help lighten, tighten brighten), retinol (to speed up cell turnover), SPF (to protect from sun damage), and Hydroquinone/Other lightening agents such as kojic acid, azelaic acid (to lighten and brighten existing pigment). Some patients are even diagnosed short-term steroids to gain control of inflammation; this will need to be initiated and controlled by a physician.

What products do you recommend? I would suggest picking at least one product from EACH category to treat melasma effectively.

Vitamin C: I will warn you that NOT all Vitamin Cs are created equal. L-Ascorbic acid is a very difficult ingredient to stabilize and although many products claim to contain vitamin C, there are very few formulations that are still active after packaging. A few of my favorites include:

Skinmedica Vitamin C + E ($102)

 

PCA Skin C + E Strength Max ($96)

 

PCA Skin C-Quench Antioxidant Serum ($74)

Retinol: Again, not all retinols are created equal. Some formulations are not “cosmetically elegant” and can cause skin irritation, redness, and excess flaking and peeling. I would recommend any of the following:

Skinmedica Retinol 0.5 and Retinol 1.0 (0.5: $78, 1.0: $93) 

 

 PCA Skin Intensive Clarity Treatment ($106)

 

SPF: PLEASE Do not minimize the importance of SPF! It is protecting you from future damage as well as skin cancer, and future aging.

Skinmedica Total Defense + Repair (Tinted + Non-tined formulations available) ($68)

  and PCA Skin Perfecting Protection broad spectrum spf 30 ($34)

Hydroquinone/Brightening Products:

Hydroquinone- Products that include this ingredient are typically available for purchase through a physician or medical practice. Hydroquinone has specific instructions for use, and they should be followed closely for safety. 

Skinmedica Lytera Brightening Complex ($130) this 4% Hydroquinone equivalent is highly effective in patients that cannot tolerate hydroquinone, or need to be on their “hydroquinone break” as directed by physician. 

Intensive Brightening Treatment 0.5% pure retinol treatment ($106) Similar to 

Lytera Brightening Complex, this hydroquinone-free complex is highly-effective in treatment pigment. 

 

PCA Skin Pigment Gel 2% Hydroquinone spot treatment can be applied to specific patches of pigment on the face. A 2% may be ideal for someone new to using hydroquinone, or that cannot tolerate a full 4% formulation. 

 

For questions or comments, please post below or feel free to contact me at the office. You may schedule a complimentary consultation at any time and we can review the specific needs for your ideal skin health.

For appointments, please call: 480.214.9955 and ask to schedule with Annie Bruno, RN.  

Be well,

Annabelle

xo