Hyperpigmentation is a discoloration of the skin that shows up as brown spots or patches. There are many causes of hyperpigmentation and it can occur on all skin tones from the lightest Fitzpatrick 1 to the deepest Fitzpatrick VI.
Melasma, also referred to as pregnancy mask or chloasma, is identified by dense areas of pigment in the central third of the face. Very often these patches are symmetrical and resemble a butterfly.
Melasma is most commonly seen in women with darker skin types, Fitzpatrick IV, V and VI. It is also commonly seen in men and women of Native American descent (on the arms) and those of German/ Russian Jewish descent on the face in the outer cheek area.
Pregnancy, hormonal contraceptives, hormone replacement therapy, even perfumed aftershaves on men can all play a part in the development of melasma. However, the common denominator present is UV exposure which stimulates the overproduction of melanin seen in all cases.
There are 3 categories of melasma: epidermal, dermal and mixed. A Woods Lamp or Skin Scanner is the best way to identify what your client is experiencing. Superficial epidermal pigmentation fluoresces or deepens under a Woods Lamp while deeper or dermal pigmenting tends to disappear.
Epidermal melasma is most common and can be effectively treated in the medspa. Melanocyte cells responsible for melanin production reside in the basal layer of the epidermis and with natural cell turnover the pigmented cells move to the stratum corneum and desquamate. With proper home and in clinic treatment, the over active melanocytes can be controlled and more even skin color is the result.
Dermal melasma is formed from too much melanin being produced too fast and what are called pendulous melanocytes which deposit melanin in the dermis. Not only does the dermis not renew itself the same way as the epidermis, but there are also Melanophage cells in the papillary layer of the dermis that ingest melanin and hang on to it.
Dermal pigmentation is difficult to treat and expectations need to be managed accordingly. Some patients regardless of treatment will see minimal change.
Mixed melisma is harder to determine as the epidermal pigment may show up darker or fluoresce under the Woods Lamp/ Skin Scanner, but there still may be dermal melasma underneath.
Melasma may resolve after pregnancy or with discontinued use of hormone therapy (including birth control) however it can be permanent.
There are several treatments available to address and improve melasma. Pigment lightening ingredients in home care regimens must be used. Ingredients such as arbutin, vitamin C, kojic acid help to control the over production of melanin. SPF 30 minimum must be used daily along with hats & visors to shield from direct UV rays year round.
In the Medspa, a series of 10% TCA depigmentation peels will deliver lighteners such as Azelaic Acid & Alpha-Arbutin down to the melanocyte without inflaming the skin (which can cause more pigmentation to occur.) Progressive not aggressive is the key when treating melasma. Pre and Post care home products must be used as recommended to achieve optimal results.
In the past lasers were used most often for pigmentation disorders such as post inflammatory hyperpigmentation & sun induced hyperpigmentation, but were not used to treat melasma because any inflammation can trigger pigment production in this condition.
However, we are happy to announce we now have a new laser called ADVATX that is designed to specifically target melasma. We also utilize the skin needing combo with light laser treatment to reduce the melasma.
MN Brow Lash Studio & Academy 5500 Lincoln Drive, 120-140 Edina MN | www.mnbrowlashacademy.com | 952-938-0358