Hyperpigmentation and Melasma
MeYour skin has color which comes from cells called melanocytes. Sometimes melanocytes become overstimulated and produce more melanin, the substance that actually gives color to your skin. Melasma is an acquired pigmentary condition, more common in the face, in females and in darker skin types. Melasma is symmetrical, occurring a central facial pattern (forehead, nose, upper lip, cheeks and chin. It is then sub classified into epidermal, dermal or mixed depending on which skin layer the pigment is in. Hormones, inflammation, UV- light,
drugs and increased skin vascularity all affect melasma.
Inflammation and Your Skin
So, what is hyperpigmentation or PIH (post inflammatory hyperpigmentation)? This is an acquired increase in pigment in the skin because of inflammation. The inflammation can be induced by acne, folliculitis, eczema, as a result of trauma, such as burns and insect bites, certain medication or secondary to laser treatments. PIH occurs equally in males and females and is more common in darker skin (Fitzpatrick 3 and higher). Both melasma and PIH are chronic conditions which can be improved upon but not cured.
Treatment Options
Treatment options include topicals, chemical peels and lasers. Topicals should always be the first choice and if the pigment is in the epidermis it will respond to them but takes a while. Examples of topicals include a tyrosinase inhibitors (a step in the pathway of making melanin) such as hydroquinone, azelaic acid, kojic acid, 4-n-butylresorcinol, and our favorite, MBR Skin Lightening Serum. Retinoids, vitamin c, niacinamide and tranexamic acid are also lightening agents. Topicals work well in combination and as pretreatments to chemical peels and lasers. Chemical peels may use glycolic or salicylic acid or trichloroacetic acid. The peel will have to be a little deeper with penetration into the dermis to remove pigment and this runs the risk of recurrent pigmentation as it heals.
Topical treatments require a commitment. It may seem like let’s just go ahead and do a laser treatment and knock it out, but it’s not that simple. More than one treatment is necessary to see a reduction in pigment and sometimes, especially in the case of melasma, the heat generated in the treatment will increase the
pigmentation. For best results in longstanding cases, we prefer pretreatment and post treatment with topicals. In summary, treating PIH and melasma is not easy and may require everything outlined above as well as SUNSCREEN and a HAT!
Contact us today to schedule an appointment!