• Dr. Dhara Patel

MELASMA

Updated: Sep 18, 2019

This may come as a surprise, but I have to say the number one complaint I see in my practice is Melasma. It's always the same story. "After my pregnancy, brown spots began appearing on my face". "I am in menopause and now my brown spots won't go away". If you are one of these people I am sure you have googled your skin and have tried homemade masks and skin bleaching agent. Many of you may have sought out advice from various experts and have gotten different answers. Unfortunately, there is no cure to melasma however to fully understand melasma and it's treatments we first have to understand what's going on.


Melasma is caused by three things: sun, heat, and hormones. We know that these triggers cause your body to increase the levels of alpha-melanocyte-stimulating hormone and adrenocorticotropic hormone, which in turn upregulate melanocyte proliferation and melanogenesis. All three increase your body's production of hormones which then causes your melanocytes (cells that produce pigment) to start multiplying and traveling to various parts of the body.



This, in turn, causes the cell to also start producing more pigment. Now you might ask if we know all this why can't we treat it? Well, there is good news and bad news. Yes, we understand this process and there are treatments to slow down the production of melasma but, there is no cure to completely reverse it yet. We also don't know what other triggers are out there. Thankfully the field of aesthetic medicine is advancing every day and who knows, we may have an answer soon. In the meantime what is a person to do?


Treatment of Melasma is a 2 step approach: lighten what's there as much as we can and prevent it from getting worse and spreading. If you are genetically prone to melasma because you see it in your parents or grandparents there are some simple things you can do. First and foremost avoid the sun. You don't have to become a vampire but, limit sun exposure as much as possible. When you are out in the sun, make sure you have a good antioxidant on board (refer to the skin care blog for more information), and wear sunscreen that has Zinc and Titanium in it. These are the two physical protectants that will reflect the sun rays. To all who live in Houston avoiding heat is a challenge but, most people don't realize hot tubs and saunas also make melasma worse. The third trigger is hormones. At Renew Laser & Skin we offer bioidentical hormones (stay tuned for that blog).


Now if you already have melasma there are several ways to make it lighter and keep it from spreading. Various topical bleaching agents as part of your daily skin care regimen can significantly improve the appearance. While Hydroquinone is still the king, Tranexamic acid is quickly taking the lead. At Renew Laser & Skin we carry several great products and are happy to help you find the right one for you. Quick disclaimer: YOU WILL NOT NOTICE A DIFFERENCE IN 4 WEEKS!!! Topical agents work, we have proven this with multiple studies, but, they don't work overnight. Any skin care product no matter what it's targeting takes at least 6 months to work. These agents are for prevention, so even if you don't see a difference, you would be worse off without them.


Now the best way to lighten is chemical peels and lasers. I have found that combination treatments always work better. One thing to keep in mind is that chemical peels and lasers are are not for everyone. Make sure whoever is treating you understands your skin type so they can pick the right treatment. Chemical peels and lasers can result in hyperpigmentation and burns if not done properly or on the right candidate.


Lucky for my Houston people we just happen to have the newest laser technology that specifically targets melasma and pigmentation. Houstonians meet the Enlighten Laser by Cutera. PICO Genesis is a treatment that safely breaks up pigment without harming the surrounding skin and can be used on all skin types. Best part…..THERE'S NO DOWNTIME. You can come during your lunch break, spend less than 30 min and be back at work and no one needs to know about it. Well, you may wanna tell your friends with melasma about it...just saying...it's what good friends do.


Learn about our 20% off rejuvenation package here.

Email us at info@renewlaserandskin.com or call 832.491.2852 for more information or to book an appointment!

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