If you've ever noticed areas of patchy darkened skin on your face you’re certainly not alone. This condition called melasma is a very common skin condition that affects up to 50% of pregnant women and up to 33% of the general population(1)
In this blog post I’m going to cover some important topics that will help you on your journey to healing your melasma once and for all:
- My two fold approach to treating melasma
Ok so let’s get right into it! What is melasma and how does it behave? Melasma is the patchy darkening of the skin on the face. It’s sometimes called ‘pregnancy mask’ as up to 50% of women experience melasma during pregnancy 1 . This condition can be caused by, and triggered by, many different stimuli such as hormones, genetics, sun exposure, infrared light, heat, etc. So treating it can be a bit tricky if you don’t know what you’re doing - that’s where dermatologists and laser specialists like myself come into play!
Melasma is treated by stabilizing the melanocytes, the little factories in our skin that create melanin, and removing the stubborn ‘stuck’ pigment that sits below the skin’s surface. Once your current Melasma has been removed it’s imperative to maintain your results at home with products for lightening and protecting. But we’ll get into all of the at home products in just a minute, first let’s start with lasers and if and how they can be used for Melasma.
There is a lot of conflicting information circulating about whether or not lasers are safe to use for Melasma - my answer to this, as a board certified cosmetic dermatologist and laser specialist, is YES some lasers are safe to use, when used correctly!
My favorite laser for this condition is the Clear and Brilliant 1927 nanometer handpiece. This is a gentle, safe, and effective laser used to treat melasma. It is superficial, so you won't risk traumatizing the skin, but you will likely need multiple treatments. I’ve found that this laser gives elegant results in all skin tones and requires no downtime.
Another laser that I like to use for melasma is called a Pico Laser. This laser uses ultra-short pulses of energy to shatter the stuck melanin under the skin. Your immune system then comes in and clears it away. There is no heat associated with this device so it’s safe on all skin tones and won’t cause post-inflammatory hyperpigmentation. This treatment is more aggressive than the Clear and Brilliant and requires about 5-6 days of downtime.
Lastly, the VBeam laser is another option for treating melasma. This one is generally used for people with rosacea as it treats redness and blood vessels. The reason it works for melasma is that it has been shown that areas with excess pigment also have extra blood vessels under that pigment. So this laser rapidly removes the melasma patches, and despite the little bit of heat associated with the treatment it does not make pigment or melasma worse.
Now onto the laser that I don’t recommend for melasma - fraxel.
Fraxel restore is an amazing treatment for anti-aging, but not one that I recommend for melasma. If you are trying to use it for melasma there is a strict protocol you’ll need to follow, including the use of Hydroquinone before and after treatment. It produces amazing results for erasing acne scars, but generally it is really difficult to use for melasma without causing excess trauma to the skin.
When I’m working with melasma patients I like to use a two-fold approach. By this I mean that I want to work to minimize the rate at which melanin is being produced, and lighten any existing patches at the same time. This works to clear up the current melasma as well as prevent new melasma from cropping up. This technique includes the use of home-care products such as alpha hydroxy acids, chemical exfoliants, hydroquinone, as well as in-office laser treatments.
So now that we have beautiful and even toned skin let’s talk about how to maintain these results at home. This simply requires being diligent with your skincare routine as well as protecting your skin from environmental assaults like UV exposure.
Some of my favorite ingredients for homecare use are:
You didn’t think you’d get a blog post without the mention of sunscreen did you? SPF is a hugely important component for preventing the recurrence of melasma! Protecting your skin from UVA/UVB, infrared, blue, and fluorescent light is imperative as these all stimulate melanin production. Using a high quality SPF like Colorscience is important in maintaining your results.
Even if you’re not in the sun the lights we experience from devices and inside our homes and work can also stimulate that pigment. So make sure you’re protected from all angles, every day.
My last recommendation is to take my favorite sun care supplement called Heliocare! This is a plant based enzyme that helps your body process sun exposure from the inside out. It’s something I personally take and love.
So that was a lot, I know! But if you want to dig a little deeper and learn some more about the science of melasma (and my thoughts on the safety of hydroquinone!) check out my YouTube video all about melasma below.
1. “Melasma”, The Cleveland Clinic, 2017, https://my.clevelandclinic.org/health/diseases/21454-melasma