Melasma 101, Part Two

TGIF! Yesterday we discussed what Melasma is- today we are going to talk about different options for treatment!

Your Regimen, Your First Line of Defense

Repeat after me: SPF is your BFF. Melasma can be exacerbated by sun exposure and heat. What this means for you is that you need to protect your skin from direct sun as well as from heat that can get trapped in the skin. Choose a mineral sunscreen only. A mineral sunscreen is a physical block, which repels heat. The mechanism of chemical sunscreens is such that UVA and UVB rays do reach the epidermal junction where they get shattered or dispersed. This is all fine, if you don’t suffer from melasma and hyperpigmention. If you do, this traps heat in your skin, and heat aggravates melasma. Try Elta MD’s UV Elements, which is a pure mineral sunscreen.

Topical Lightening Agents

Also known as tyrosinase inhibitors, these topical products inhibit melanocytes during their cell cycle (called melanogenesis). Examples of some of the ingredients in these products are hydroquinone, kojic acid, beta arbutin (the molecular structure of beta arbutin is bio-identical to hydroquinone, but releases the hydroquinone at the epidermal junction rather than at the surface of the epidermis and so it causes less irritation and sensitivity). Hydroquinone is still a controversial ingredient, as studies as shown it to be possibly carcinogenic- follow your dermatologist or medical aesthetician’s advice if you are using this product. Some lightening agents you can be on for only 3 months, whereas others you can be on indefinitely. They can make a big difference in gradually lightening the pigment found on the skin.

Retinol

Retinol, or Vitamin A is a natural tyrosinase inhibitor. It increases cell turnover, lightly exfoliates, also causes cell proliferation and gently reduces tyrosinase activity on the skin.  Tyrosinase is a copper-containing enzyme present in plant and animal tissues that catalyzes the production of melanin and other pigments from tyrosine by oxidation, as in the blackening of a peeled or sliced potato exposed to air. So, retinoids work to reduce that activity and can lighten hyper-pigmentation over time, As an exfoliant, retinol can also allow the lightening product to penetrate the skin more deeply, as well as encourage cell turnover to help quickly slough off the top pigmented layer.

Vitamin C

As an antioxidant applied in the morning, Vitamin C helps to create a protective layer of cells on the skin to protect it from UVA and UVB rays. With the right formulation, Vitamin C can also help to lighten pigment over time as well (think of how your skin reacts if you get lemon juice on it)

Professional Treatments

Your skincare professional such as your Dermatologist, PA-C, RN or Licensed Medical Aesthetician can prescribe a course of treatment most suitable for your melasma and get you on the path to an improved complexion. Some treatments and modalities may include chemical peels (typically medium in depth), microdermabrasion, and possible laser treatments (although most are not appropriate for melasma, as the heat induced during a laser treatment can make melasma worse!)

Reducing Heat in the Skin

As I stated in the beginning, sun protection is very important, but also making sure the skin does not get overheated. If you are sitting under a tent wearing a hat on a 100 degree day at the beach, even if the sunlight doesn’t touch your face, you may still be at risk for a flare up. I recommend keeping as cool as possible, and also taking a cool mist of water with you to spray your face periodically (just make sure the mineral sunscreen is intact!) If you flare up, try not to panic. You can go back to your topical and your treatments and in all likelihood any pigment that come back can be treated.

Thanks for stopping by! XO Ashli

 

Leave a Reply

Your email address will not be published. Required fields are marked *