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Melasma is blotchy areas of brown skin pigmentation on the face. Melasma, (also known as chloasma), appears as blotchy pale brownish pigmentation on the face, especially forehead, cheek and upper lip. It is more common on darker skin types. It is especially common in women aged 20-40 and is associated with pregnancy or taking the contraceptive pill or injection. It also happens in healthy, non pregnant woman taking no medications and men using aftershave.

Epidermis Melasma

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Dermal Melasma

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Mixed Epidermis and Dermal Melasma

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There is a genetic predisposition to melasma but triggers may include:

• Hormonal contraceptive including the oral contraceptive pill and injected progesterone.
• Sun exposure
• Antibiotics and many other medications wich are photosensitising (including those commonly prescribed for acne).
• A phototoxic reaction to scented or deodorant soaps, toiletries and cosmetics.
• Pregnancy from hormonal change - often fades a year later but can persist.
• Unknown factors
• Melasma usually affects women; only 1 in 20 affected are male. It generally starts from the age of 30. Melasma is more common in people that tan easily or have naturally darker skin.

Sun exposure following some cosmetics can cause a phototoxic reaction where the chemical substance absorbs UV light. The resulting pigmentation extends where sun and cosmetic use have coincided, for example down the neck, often more on the right side in countries that drive on the left.

Melasma is more stubborn to treat than freckles or age spots because the melanocytes have become sensitized and continue to produce extra pigment with even the slightest hint of sun. Sun protection is an essential part of treatment.

Consider stopping hormonal medications although it may be many months before any benefit from this becomes apparent. Fading creams containing hydroquinone, alpha-hydroxy acids, retinoids or Vitamin C inhibit new pigment formation. Microdermabrasion, Lasers and chemical peels can reduce existing pigmentation but should be used carefully as skin with melasma is more prone to postinflammatory hyperpigmentation. Cosmetic camouflage using special make up is another approach. It is important that you see an experienced doctor before embarking on any treatment as melasma is a particularly difficult condition to treat and is often misdiagnosed by beauty therapists who treat melasma with skin treatments or IPL that may make the condition worse.

Hairfaceclinic has the best available laser for treating melasma, the Fractional CO2 laser. This is a revolutionary new laser which improves melasma by fractional resurfacing of the skin. This decreases the melanocyte population so less melanin is produced. Fractional laser is the first laser to be approved by the American FDA for melasma and can be used on Asian, Polynesian, Maori and European skin.

Fotona QX-MAX laser is also powerful laser to treat melasma with special adjustment to target melasma at different skin level. Dermal melasma is best treatment with small spots laser and Epidermis melasma is easily treated with big spots of laser aperture.

PRP with précised Derma Queen injector is the best option to treat the Melasma. It is very effective and about 50% to 65% improvement can be seen after one PRP treatment.

The following can prevent melasma from getting worse:

Wear sunscreen and a wide-brimmed hat every day. Because sunlight triggers melasma, aesthetic doctor recommend wearing sunscreen daily, year-round. This is important because some of the sun’s UV rays can touch the skin — even through clouds and windows.

• Be sure to use sunscreen that offers these 3 things:
• Broad-spectrum protection (protects against UVA and UVB rays).
• A sun protection factor (SPF) of 30 or more.
• Zinc oxide or titanium oxide to physically block the sun’s rays.
• You should apply sunscreen every day. Be sure to apply it 20 minutes before you go outside.
• Use your medicine exactly as directed by your dermatologist. This is very important.
• Cover up the patches. You may want to cover up your dark patches with makeup. Choose products that have white and yellow undertones