Pigmentation

Pigmentation (Melasma)

It is a common skin problem. It causes brown to gray-brown patches, usually on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip. It also can appear on other parts of the body that are exposed to the sun, such as the forearms and neck.

Women are far more likely than men to get Pigmentation. It is very common during pregnancy and sometimes called "the mask of pregnancy." Hormones seem to trigger Pigmentation.

  • 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 is also 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.
  • Skin care products: If a product irritates your skin, melasma can worsen. So it is advisable to consult your dermatologist/ Cosmetologist before applying any skin care product.

Though Melasma is not a life-threatening problem as it mainly affects the face, pigmented patches lead to unpleasant look which may affect the personality and confidence.

There are two stages of Melasma, one that is affecting superficial, epidermal layer only (outer layer) of skin, and the other which may penetrate into the dermis (deeper layer) of skin. Sometimes there is a combination of both which is called as mixed melasma.

Once Melasma reaches the deeper layer of skin it may result in permanent discoloration which is difficult to treat. Therefore, timely treatment is important.

As the saying goes “Prevention is better than cure" protecting skin from the sun is the most important precaution for which use of sunscreen is mandatory. The sunscreens available in the market are to be used cautiously as their use and effectiveness depend on the type of skin and SPF of the sunscreen.
Other options like topical creams including hydroquinone, superficial peels, and laser therapy are available which can be used in combination. Therefore prior assessment by Dermato-Cosmetologist is a must before using them.

  • Wear sunscreen daily: One of the most common treatments for melasma is sun protection. Since sunlight triggers melasma, it is important to wear sunscreen every day, even on cloudy days and after swimming or sweating. Choose a sunscreen that offers broad-spectrum protection, a Sun Protection Factor (SPF) of 30 or more, and zinc oxide and/or titanium dioxide to physically limit the effects of the sun rays on your skin. Apply sunscreen 15 minutes before going outside and reapply at least every two hours.
  • Wear a wide-brimmed hat and sunglasses when you’re outside: As a recent study in the journal Nature illustrates, sunscreen alone may not give you the sun protection you need. Whenever possible, seek shade and wear protective clothing in addition to applying sunscreen.
  • Choose gentle skin care products: Choose skin care products that don’t sting or burn, as products that irritate the skin may worsen melasma.
  • Chemical peels can improve melasma by removing the outermost cells of the skin that contain the pigment. Chemical peels should be undertaken by an experienced practitioner as they could make the pigmentation worse, lighten the skin too much or cause scarring.At Dr Manoj Agarwala’s M A Skin & Hair Superspeciality Clinic, Raipur, we use customized special chemical peel - Melasma Magic peel for better outcomes.
  • Microneedling is a process where the skin is repeatedly punctured with tiny needles to help creams penetrate deeper into the skin.
  • Laser therapy is one of the treatment options for both superficial and deep Melasma. Some types of laser also remove the outer layer of skin, whereas others target the pigment-producing cells (melanocytes). This procedure should only be performed by a highly experienced laser surgeon. It is important that low energy laser should be used for Melasma. Dr Manoj Agarwala’s M A Skin & Hair Superspeciality Clinic we have the state of Q switched lasers for effective treatment of Melasma.

Melasma can be permanently removed as long as there are no hormonal imbalances that will trigger a Melasma reoccurrence. Combined with adequate sun protection, such as protective clothing, sun screen with a high SPF, and limiting the time spent in direct sunlight, you can prevent the return or persistence of Melasma.
It is important to understand that Melasma treatment involves multiple combinations of therapies with the individualized approach, which requires experience on the part of Dermato-Cosmetologist. Dr Manoj Agarwala has rich experience by virtue of his training at prestigious CMC Vellore in the field.

M A Skin & Hair Clinic