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Melasma Treatment

General Information

Melasma is a common skin problem. It causes brown to gray-brown patches on the face. Common signs (what you see) of melasma are brown or gray-brown patches on the face. These patches most commonly appear on the:

  • Cheeks

  • Forehead

  • Bridge of the nose

  • Above the upper lip

  • Chin

Melasma is most common among pregnant women, especially those of Latin and Asian descents. People with olive or darker skin, like Hispanic, Asian, and Middle Eastern individuals, have higher incidences of melasma.

       

Who gets melasma?

Melasma appears on women’s skin much more often than men’s skin. Just 10% of people who get melasma are men.

People with darker skin, such as those of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent are more likely to get melasma. People who have a blood relative who had melasma also are much more likely to get melasma.

Cause of melasma

 What causes melasma is not yet clear. It likely occurs when the color-making cells in the skin (melanocytes) produce too much color. People with skin of color are more prone to melasma because they have more active melanocytes than those with light skin.

Common melasma triggers (what starts it) include:

  • Sun exposure: Ultraviolet (UV) light from the sun stimulates the melanocytes. In fact, just a small amount of sun exposure can make melasma return after fading. Sun exposure is why melasma often is worse in summer. It also is the main reason why many people with melasma get it again and again.

  • A change in hormones: Pregnant women often get melasma. When melasma appears in pregnant women, it is called chloasma or the mask of pregnancy. Birth control pills and hormone replacement medicine also can trigger melasma.

  • Cosmetics: Skin care products that irritate the skin may worsen melasma

Skin care and melasma prevention

1.     Proper skin care, periodically.

2.     Avoid contacting directly with sunlight: wear a broad-brimmed hat, use a mask, sun cream and restrict to contact with the sun from 10 a.m to 4 p.m.

3.     Avoid using products with strong detergents, skin scream that can irritates the skin.

4.     It’s necessary to avoid the light when using products with strong detergents, medicines increase the light sensitiveness.

5.     Do not use products without origin, causing irritation and skin allergy.

 

The solution for this hyper-pigmentation problem was first introduced and only at Orient Clinic Center.

It is:

        AURORA machine with SR filter, including light energy (IPL) which has wavelength 580-980 nm generate heat energy 10-45 J/cm2 and  electromagnetic energy (RF) 1MHz has wavelength 1 MHz generate heat energy heat energy 5-25 j/cm3.

        Melanin pigment concentrates on the upper epidermis which is proved to be best         absorbed with a powerful pulsated laser light of wavelengths 580-980 nm. The         combination of both of types of light energy (IPL) and electromagnetic energy (RF)        creates a sufficient and appropriate heat energy to break melanin molecules into small         pieces. And then, the fragments of this melanin will be eliminated gradually. With this mechanism, AURORA SR machine helps with fading freckles, red or brown spots        70-80%.

       Melasma Treatment at Orient Clinic

Aurora-ELOS treatment is an advanced type of Intense Pulse Light treatment or IPL. IPL uses light pulses to heat the lower layers of the dermis promoting collagen production and working to remove unwanted hair by targeting pigmented hair follicles. Aurora-ELOS advanced IPL combines electrical radio frequency (RF) to create a heat/radio related pulse solution to not only remove the lighter pigmented facial hair but also to promote skin rejuvenation. The unique combination of Aurora-ELOS treatment allows those with darker pigmented skin to be treated.

Fraxel® is proven laser technology that can help reverse the visible effects of aging, naturally helping you look as young as you feel. With Fraxel, change isn’t drastic or scary – it’s you, just younger.

Fraxel is effective on:

  • Fine lines and wrinkles – like crow’s feet and brow lines

  • Surface scarring – erasing effects of acne and other scarring

  • Pigmentation – minimizing the appearance of age spots

  • Sun damage – helping heal dangerous skin damage

  • Actinic Keratosis (AK) – a common pre-cancerous skin condition


    Q-switched Nd:YAG laser therapy is becoming common for skin rejuvenation and the treatment of various skin imperfections, among them Melasma. This treatment modality has proven to be especially popular in the Asian world.

    Melasma is a difficult to treat condition with a high rate of reoccurence. Current first line therapies include topicals such as hydroquinone and arbutin. Some investigators have found Q-switched Nd:YAG laser therapy to be a safe and effective in the treatment of Melasma.

    Additionally, skin treatment in combination with the following methods will help to support significantly to the treatment’s results:

    ·       Ultrasonic therapy: This technique is based on the mechanism of action of ultrasonic waves and rhythmic movements and create steady vibration stimulus in small intensity to deliver good-endosmosis of substances to the skin.

    ·       Iontophoreris therapy: is a technique which delivers charged particles of vitamins and minerals into the skin by using electrical current

    ·       Meso therapy: is a special technique used in skin cosmetology, which origins from Europe. It is applied in many countries in the world now. Meso therapy uses a specialized tool to deliver vitamin solution or nutrient solution deeply into the skin.

    ·       Micro-dermabrasion: is a super-abrasive technique that usesa small tip contains very fine smooth particles of mineral crystal or tip of diamonds. When operating rhythmically on the surface of skin, this will remove thoroughly dead cells and help your skin to become brighter and smoother.

    1. How is the diagnosis of melasma made?

    Your physician can usually diagnose melasma based upon the appearance of your skin. Your physician may want to examine your skin with a Wood’s lamp to help guide treatment.

     2. What treatment options are available?

    The best treatment for melasma is prevention. The key to preventing melasma is sun avoidance and daily sunscreen use. However, for most of us, it is too late for prevention, and there are a number of treatment options available at Orient Clinic.

    Bleaching Creams

    3. What they are?

    Over-the-counter creams contain 2 percent hydroquinone, a bleaching agent. Prescription creams may use single agents, such as Retin-A (tretinoin) or combinations of medications such as hydroquinone with tretinoin plus a cortisone cream.

    4. What are the risks?

    Over the counter bleaching creams are usually well tolerated and may gradually lighten melasma over a couple of months. However, they are not very effective. Prescription formulations are often more effective but may have more side effects (such as redness, drying, and peeling) and are expensive. Creams may not work for everyone and the risks and benefits need to be discussed with your physician.

    Intense Pulsed Light Therapy (IPL)

    5. What is it?

    IPL is one of the newer forms of facial rejuvenation. Unlike lasers, which use intense, focused light, IPL is intense broadband light. Although IPL delivers energy to both the superficial and deep layers of the skin, the epidermis is spared from damage. Thus, there is virtually no recovery time. In the studies that have been performed so far, IPL can smooth the skin and fade age spots, freckles, melasma, and even broken blood vessels. Improvements usually last for about a year with good sun protection.

    6. What are the risks?

    IPL is safer than laser therapy because IPL does not damage the epidermis. There may be some pain during the procedure but no recovery time. Unlike laser therapy, however, you may need multiple treatments (average is 4-6, at three weeks intervals) to get the full benefit. The cost is variable, but is usually more expensive than peels and less expensive than lasers. The risks and benefits of IPL therapy need to be discussed in detail with your physician.

    7. What SPF is recommended for Melasma?

    If you have Melasma, or want to prevent it, a daily sunscreen with a sun protection factor (SPF) of at least 30 is recommended to block UV rays.  The sunscreen should contain physical blockers, such as zinc oxide and titanium dioxide.   Other chemical blockers may not fully block both types of UV-A and UV-B as effectively as zinc or titanium.

    8. Can Melasma be cured?

    There is no known cure for Melasma.  Melasma is a chronic condition that develops slowly and so it tends to clear slowly. The gradual disappearance of dark spots is based on establishing the right treatment combination for each individual.

     9. My Melasma returned – what happened?

    If Melasma is not responding to treatment, or you had a treatment that worked for a while, but now the condition has returned – it is possible that you are not avoiding exposure to the sun.  Wear protective clothing, a hat, and apply a sunscreen with zinc oxide and titanium dioxide every time you go outdoors to prevent the return, or persistence, of Melasma.