MELASMA
What is melasma
Melasma is a chronic skin disorder that results in symmetrical, blotchy, brownish facial pigmentation. Melasma can also affect the arms and back. It can lead to considerable embarrassment and distress.
Who gets melasma:
Melasma is more common in women than in men; only 1-in-4 to 1-in-20 affected individuals are male, depending on the population studied. It generally starts between the age of 20 and 40 years, but it can begin in childhood or not until middle age, Melasma is more common in people that tan well or have naturally brown skin (Fitzpatrick skin types 3 and 4) compared with those who have fair skin (skin types 1 and 2) or black skin (skin types 5 or 6).
What causes melasma:
The cause of melasma is complex. The pigmentation is due to overproduction of melanin by the pigment cells, melanocytes, which is taken up by the keratinocytes (epidermal melanosis) and deposited in the dermis (dermal melanosis, melanophages). There is a genetic predisposition to melasma, with at least one-third of patients reporting other family members to be affected. In most people, melasma is a chronic disorder.
Known triggers for melasma include:
Sun exposure and sun damage — this is the most important avoidable risk factor. Visible light and ultraviolet rays contribute to abnormal pigmentation.
Pregnancy — in affected women, the pigment often fades a few months after delivery.
Hormone treatments — oral contraceptive pills containing oestrogen and progesterone, hormone replacement, intrauterine devices and implants are a factor in about a quarter of affected women.
Certain medications (including new targeted therapies for cancer), scented or deodorant soaps, toiletries and cosmetics may cause a phototoxic reaction that triggers melasma, which may then persist long term.
Melasma commonly arises in healthy, non-pregnant adults. Lifelong sun exposure causes deposition of pigment within the dermis, and this often persists long-term. Exposure to ultraviolet radiation (UVR) deepens the pigmentation because it activates the melanocytes to produce more melanin.
Melasma commonly arises in healthy, non-pregnant adults. Lifelong sun exposure causes deposition of pigment within the dermis, and this often persists long-term. Exposure to ultraviolet radiation (UVR) deepens the pigmentation because it activates the melanocytes to produce more melanin.
Vascular pertains to blood vessels and lymphatic vessels.
A melanocyte is a cell found in the basal layer of the epidermis that produces a protein called melanin that protects the skin from damage due to ultraviolet radiation.
What are the clinical features of melasma:
Melasma presents as macules (freckle-like spots) and larger flat brown patches. These are found on both sides of the face and have an irregular border. There are several distinct patterns.
Centrofacial pattern: forehead, cheeks, nose and upper lips.
Malar pattern: cheeks and nose.
Lateral cheek pattern.
Mandibular pattern: jawline.
Reddened or inflamed forms of melasma (also called erythrosis pigmentosa faciei).
Poikiloderma: reddened, photoaging changes are seen on the sides of the neck, mostly affecting patients older than 50 years.
Brachial type of melasma affecting shoulders and upper arms (also called acquired brachial cutaneous dyschromatosis).
Melasma is sometimes separated into epidermal, dermal, and mixed types. A Wood lamp that emits black light (UVA1) may be used to identify the depth of the pigment.
There are three types of melasma diagnoses: epidermal, dermal, and mixed.
Treatment options:
Spectra laser:
The nanopulse Nd: YAG laser is the gold standard in treating moderate and deep pigment disorders and more recently melasma. Spectra was cleared in 2012 for the treatment of melasma, and has shown to be very effective in reducing the appearance of melasma. Individuals receiving treatment should always wear sunblock if going into the sun and avoid sun exposure which can retrigger pigmentation.
750ns pulses disrupt melanosomes through a photoacoustic disruption (longer pulse durations (eg, 400 microseconds) do not)
This is consistent with the theory of selective photothermolysis, which states that the pulse duration of an emitted laser wavelength must be less than the thermal relaxation time of the targeted object A typical 1-µm melanosome has a thermal relaxation time of 0.5-1 μs.
Picoway laser:
The unique picosecond laser technology of PicoWay removes benign pigment spots including; freckles, solar lentigines (brown spots on face), and melasma. PicoWay Resolve is a safe, effective treatment option for any skin type, and offers results in just a few treatments
Skin care:
Universkin.
Jeunesse cosmedical.
Note:
With the treatment you mention, intense-pulsed light or IPL, melasma often reappears quickly. Intense-pulsed light also carries a risk of heating the surrounding skin, which is thought to worsen melasma
Schedule Your Consultation
At JEUNESSE SPA AND SKIN CARE we will evaluate your condition and then determine which treatment plan would best suit your individual needs. Please contact our office today to schedule your initial consultation.
