NEW LASER TREATMENT OF MELASMA

New Laser Treatment of Melasma

If you have dark patches on the face, you could be one of the millions of women struggling with melasma. Commonly found among Asian women, melasma is considered the most difficult to treat among the disfiguring hyperpigmentation cases.

There are basically three types: the epidermal melasma, found in the outer layer of the skin; the dermal melasma, existing in the inner skin layer; and the combination type. Melasma is associated with age, hormonal factors, stress, genetic predisposition, pregnancy, use of oral contraception, and sun exposure.

Topical therapies such as bleaching agents (hydroquinone and kojic acid) and chemical peels (retinol and TCA), have been used but with limited success. The results are inconsistent and their effectiveness decreases with long-term use. Dermal melasma does not respond at all to any topical treatment.

Intense pulsed light (IPL) has also been used in recent years, but the results were less than expected. There were also reports of side effects related to IPL damage to the skin, particularly post-inflammatory secondary hyperpigmentation (PIH).

At SkinStation, we recently introduced DERMAX Medlight laser as an effective treatment of melasma. The laser used in MedLight is Q-Switched Nd:YAG,  which has produced successful results in several controlled clinical trials in Korea.

The MedLight laser creates an invisible beam of light that is pulsed repeatedly at a fraction of a second. The pigments in the dark patches of the skin are fragmented and subsequently reabsorbed over a 6 to 8 week period. This treatment is simple, non-invasive, with minimal risk and minimal recovery time. Some patients may feel a mild “sunburn” feeling that quickly subsides.

DERMAX MedLight is also effective in other hyperpigmentation concerns such as age spots, chemical burns, and marks caused by acne and chicken pox. Added benefits of skin toning and rejuvenation have been observed. On the average, 3 sessions at intervals of 4 weeks is prescribed, followed by maintenance treatments every 3 to 6 months.

Post treatment, our Dermatologist will require you to strictly avoid sun exposure. You will also be asked to follow a medical grade skin care regimen that will lighten, rejuvenate, and protect the skin. Our goal is to help you successfully minimize and manage your melasma.

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This column was published in the Manila Bulletin Lifestyle Section on October 28, 2014 . The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulation Commission (PRC) for his achievements in the field of cosmetic chemistry. Skin Smart aims to clarify facts and myths on skin care. Send your questions and comments to info@skinstation.ph.  

HOW TO LIGHTEN SKIN DISCOLORATIONS

How to Lighten Skin Discolorations

Skin discolorations come with many names: e.g. freckles, age spots, melasma, and PIH. These are all classified as hyperpigmentation, defined as skin darkening caused by abundance of melanin.

The location of excess melanin pigmentation is important. It is either in the outer (epidermal) layer or the inner (dermal) layer of your skin. If the skin discoloration is very pronounced, the excess pigment is probably in the outer layer. Subtle marks indicate deeper layer of pigmentation.

If the excess melanin is in the deeper dermal layer, like dermal melasma, the discoloration can be most difficult to treat. Topical remedy won’t work. Fractional lasers will not help either. The practical remedy is just a cosmetic cover up. The good news is that positive results have been achieved with multi-session Nd:Yag laser treatment.

Fortunately, most cases of skin discolorations are the epidermal type, like freckles and age spots, and non-dermal melasma.

Freckles are usually hereditary, with melanocytes producing more than the normal melanin pigments. The more you are exposed to the sun, the darker the freckles get. Daily sun protection is a must!

Age spots are small brown patches of the skin, the cumulative effect of unprotected sun exposure since birth. The number of pigment producing melanocytes is increased, leading to dark brown spots. Once age spots are formed, they remain pretty stable in their color even if you get more sun exposure.

Melasma is triggered by hormonal fluctuation, during pregnancy, and aggravated by sun exposure.

Exfoliate and lighten skin discolorations
with DERMAX Retinol C serum

Treatment options for epidermal discolorations are:

• Topical treatments with sunscreens and lightening creams & lotions
• Peels, combined with topical treatments
• Dermal roller
• Fractional lasers and Nd:Yag laser

Save on unnecessary expense by consulting first with your dermatologist. They are trained to diagnose if you have dermal or epidermal type of pigmentation. They will then prescribe the best treatment option for your specific skin condition.

 

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This column was published in the Manila Bulletin Lifestyle Section on August 5, 2014 . The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulation Commission (PRC) for his achievements in the field of cosmetic chemistry. Skin Smart aims to clarify facts and myths on skin care. Send your questions and comments to info@skinstation.ph. 

What You Can Do About Melasma

What You Can Do About Melasma

Melasma typically appears as dark, irregular, well-demarcated hyper-pigmented patches on the face, usually seen on the upper cheek, nose, upper lip, and forehead. These patches develop gradually over time.  It is a common skin disorder in women during their reproductive years, and is often referred to as the “mask of pregnancy”.

The dark patches are caused by the overstimulation of the pigment producing cells in the dermis, called melanocytes, to produce more melanin when the skin is exposed to the sun. Experts believe that increased levels of female sex hormones estrogen and progesterone, combined with sun exposure, trigger hyperactive melanin production.

Pregnant women experience increased estrogen, progesterone, and melanocyte-stimulating hormone (MSH) levels during the second and third trimesters of pregnancy. Hormone related correlation is also seen with increased incidence of melasma in women taking birth control pills, hormone replacement therapy (HRT), and those with thyroid condition.

Genetic predisposition may also be a factor, just as race can play a role. Melasma is most common among women of Asian, Middle Eastern and Latin descent. There are also antiarrhythmic, antiseizure and antibiotic medications like tetracycline that may make the skin more prone to pigmentation after exposure to ultraviolet (UV) light. Certain cosmetic preparations have also been found to cause melasma-like patches on the face.

The discoloration usually fades away over a period of several months after giving birth or after stopping the oral contraceptives or hormone replacement therapy. Unfortunately, not all the discolorations disappear. Many also experience a resurgence of the patches after prolonged sun exposure.

Avoid the sun and 

use sunscreen daily. 

Prevention is primarily aimed at having daily facial sun protection and sun avoidance. Treatment requires the same regular daily sunscreen application, with minimum of SPF30 recommended. Wearing sunscreen daily should be a continuing habit even during pregnancy, while all other forms of treatments should be done after pregnancy.

The most common melasma home remedy is a combo of lightening and exfoliating ingredients. Years ago, the preferred lightening ingredient product was hydroquinone. Misuse of blends of hydroquinone and tretinoin have been the cause of many skin discolorations on the face, particularly those who failed to include sunscreen in their daily regimen. Risks associated with long term use of hydroquinone have also prompted most countries to restrict its sale. 

For sometime, kojic acid appeared to be the chosen replacement for hydroquinone, but doubts about its safety were raised prompting Japan and Korea to ban its use in cosmetic preparations. Now, we see the market embracing natural and effective skin lightening alternatives, like licorice extract, ellagic acid, and alpha arbutin, which are all found in DERMAX NanoWhite night essence, creams, and lotions. DERMAX Retinol C serum provides a more intensive effect with its micro-exfoliation feature.

In conjunction with home cream applications, in-clinic treatment options include chemical peels by TCA or a combo of glycolic and diamond peels. CollaWhite Collagenesis is a signature microneedling procedure at SkinStation designed to minimize skin discoloration and smoothen out rough skin. Multiple treatments, in combination with daily use of DERMAX UV MILK sunscreen, lightening and exfoliant creams, yield best results. To ensure that treatment doesn't fail, sun exposure should be minimized.

Many doctors generally avoid IPL and laser therapy options for melasma. While it may work for some, many patients report a worsening of their skin discoloration. Those with melasma have excitable melanocytes that any exposure to light can trigger adverse effect. If your doctor recommends IPL or laser, ask for a second opinion.

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This was published in the July 3, 2012 issue of Manila Bulletin Lifestyle Section. The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulations Commission (PRC) for his achievements in the field of cosmetic chemistry. He can be reached at fred.reyes@skinstation.ph. (Updated on April 23, 2013.)