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“Frustrating” may be an understatement for the many women (fewer men) that struggle with this very common skin condition. In fact, this is the most common pigmented skin condition we treat in our practice. Similar to acne, this condition is oftentimes an emotional one being that both are considered non-curable and chronic and linked to a hormonal influence. However, both are manageable with good options for improvement.
Melasma comes from within. Meaning, the cells of color (melanocytes) develop on the surface of the skin, creating brown shades of color represented as patches in typical locations such as the forehead, bridge of nose, cheek bones, and upper lip. The onset may be insidious over time or may develop within a very short amount of time – weeks even.
If we understand that the discoloration is in response to hormonal influences and genetic predisposition, we must also recognize that there also triggers that exacerbate or “feed” the condition. Specifically, heat, humidity, and UV radiation (sun light). Living on planet earth, we cannot avoid all of these elements at all times and still enjoy our lives and activities. However, we can modify our routine while seeking a treatment regimen.
If heat, humidity, and light radiation all work to worsen melasma, we would never want to use a laser option as this is pure light and heat! Unfortunately, numerous medical professionals continue to use their lasers or IPLs as a treatment option and usually doing a disservice to their patient. In the event there is initial improvement of color, research over the many years will confirm that melasma will almost always return within 6 months and, in many cases, return with a vengeance. Besides this disappointing result, lasers are a much bigger expense than a topical option.
In our practice, using a topical ingredient of hydroquinone has offered a 95% success rate with our melasma patients. Success being improvement/control vs. cure. Our success rate is also based upon educating our patients on how to manage their condition, using only fresh hydroquinone that is not pre-made, and avoiding the use of lasers and heat for melasma.
As we enter into possibly another hot summer wherein the elements are wanting to trigger your melasma – don’t fret. Pull out the hat, sunscreen, hydroquinone, and enjoy your activities. You are in good company.
* Melasma Before and After Pictures