Newsletter May 2009 – Melasma

Advancements in Melasma Treatment

With summer approaching, we believe it’s an important time of year to profile one of the most difficult conditions we treat at Celibre – melasma. Melasma is a stubborn skin condition that causes brown facial discoloration. The pigment visible in melasma is hormonally generated and the condition is often present in pregnant women, those on oral contraceptives, or perimenopausal women.

Because melasma is considered chronic (meaning there is no cure), it is a very emotional condition. Very often, we evaluate potential patients that have been disappointed with previous treatment programs or may have experienced good outcomes only to have the melasma return. Even when a melasma patient has good results from treatment, without proper day to day management, it will most likely return. We educate our patients and consumers alike that the goal of any melasma treatment plan should be improvement (not cure) and effective control.

More About Melasma Treatment

Another very common statement we hear is that hydroquinone (HQ), a bleaching agent commonly used for facial discoloration, did not work for them. While it is true that most products for melasma contain hydroquinone, it is the combination of other active ingredients that sets one treatment plan apart from another. HQ comes in various concentrations. This causes confusion because the % of HQ that might not work for one individual may for another. At Celibre, both of our topical treatment programs for melasma contain HQ in prescription strengths (4% – 8%) which are far different than those HQ products purchased over the counter (2%). Our products also contain various other active ingredients to aid the depigmentation such as retinoids, Kojic Acid, and Bearberry Acid. At Celibre, we promote an individualized treatment plan for each patient. In doing so, we take into consideration their experience with other treatment plans, their response, and any potential negative side effects. It is the “recipe” that makes all the difference.

We are often asked why we do not use laser treatments for Melasma. The reason is simple – in many cases, the Melasma gets worse when lasers are used. Laser treatments are most effective at removing pigment that lies near the surface of the skin. In most cases, Melasma originates in the lower layers of skin so reaching this deeper pigment with lasers is difficult. And, in some cases treating Melasma with lasers will make it darker. Almost every case of Melasma we seen at our office that was treated elsewhere with lasers or IPL is darker than it was before the laser treatment.

Over the past 18 months, we have spent much time and effort evaluating new products for Melasma and even changing the way we use the existing products, and we are excited about the progress we have made. Currently, we use two programs for the treatment of Melasma. The first is Cosmelan MD. Cosmelan has been used by our practice for the past several years, but some recent changes in the product have made it more effective for us than earlier versions. We also have a depigmentation formulation that was developed in conjunction with a pharmaceutical company. This product, the Celibre Depigmentation Program, is also very effective at treating Melasma. The reason we use more than one program is that not all patients respond the same to each treatment, and what may work for one, may not work for another, so it’s best to have more than one choice.

At Celibre, we focus on patient education. We want our patients to understand and participate in the decisions that make up their care plan. To this end, our knowledgeable medical staff are here to help you weigh the benefits and risks of our Laser treatments.

Our team would be pleased to offer a complimentary consultation to address your skin care goals. A good starting place is to gather information and view before and after photos of Celibre patients in our photo gallery.

At Celibre, we stay at the forefront of research and best practices so that we may offer the most appropriate and effective injections and laser treatment plans for our valued patients. Please give us a call to learn more about laser treatments and injections.

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