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Melasma Treatment


Melasma is an acquired hypermelanosis of sun-exposed areas. Melasma presents as symmetrically distributed hyperpigmented macules, which can be confluent or punctate. Areas that receive excessive sun exposure, including the cheeks, the upper lip, the chin, and the forehead, are the most common locations; however, melasma can occasionally occur in other sun-exposed locations. Note the images below.

A direct relationship with female hormonal activity appears to be present and commonly develops or worsens during pregnancy and with the use of oral contraceptive pills.

Other causes for melasma are photosensitizing medications, mild ovarian or thyroid dysfunction, and certain cosmetics.

The most important factor in the development of melasma is exposure to sunlight. Without the strict avoidance of sunlight, potentially successful treatments for melasma are doomed to fail.

Melasma can be difficult to treat. The pigment of melasma develops gradually, and resolution is also gradual. Resistant cases or recurrences of melasma occur often and are certain if strict avoidance of sunlight is not rigidly heeded.

Prophylactic management is often the most effective means of prevention. Avoidance of sun exposure and use of high-SPF sunscreens (50+) can prevent the development of melasma.

UVB protection:

Strict sun avoidance is essential for resolution and to prevent recurrence of melasma. Patients with melasma should apply bleaching creams to areas of darkening only. Resolution with strict sun avoidance and topical bleaching creams can take months; caution patients to expect slow but gradual lightening.

melasma is much more common in constitutionally darker skin types than in lighter skin types, and it may be more common in light brown skin types, especially Latinos and Asians, from areas of the world with intense sun exposure.Women are affected in 90% of cases. When men are affected.

Melasma can be difficult to treat. The pigment of melasma develops gradually, and resolution is also gradual. Resistant cases or recurrences of melasma occur often and are certain if strict avoidance of sunlight is not rigidly heeded.

What can be done for malasma?

  • Depigmenting skin products:

Hydroquinone produces reversible depigmentation of skin by inhibiting enzymatic oxidation of tyrosine.

Azelaic acid may decrease microcomedo formation. It may have a bleaching effect on skin. It may also have an antimicrobial effect.

Topical tretinoin (vitamin A) inhibits microcomedo formation and eliminates lesions.

Fotona Qswitch laser:

Pigmented lesions are remarkably common and the overwhelming majority are benign. It is widely recognized in the medical community that Q-Switched lasers are the ideal tools for effectively removing benign pigmented lesions. Multi-wavelength, Q-Switched laser systems with frequency-doubled KTP are uniquely able to produce very short pulses of intense light that are selectively absorbed by treatment-specific pigments in a lesion.

How does laser treatment reduce excessive skin pigmentation ?

Our clinic offers Fotona QX MAX laser treatment which is suitable to correct most types of pigmentation disorders and is safe to treat darker skin types. The laser works by delivering an intense beam of light that is absorbed by skin pigments (melanin) only. This light is converted into heat energy that destroys the melanin, leaving surrounding skin structures intact. Unlike topical creams, laser energy can target deeper within the dermis, so dermal (deeper) pigmentation can be effectively treated as well.

Does treatment with Fotona QX MAX Laser cause thinning of the skin ?

No, this laser treatment does not cause skin thinning. The procedure may sometimes induce temporary mild redness and dryness that is mistaken by some as the effects of thinned skin. The laser energy selectively destroys excessive skin pigments and does not strip away layers of the skin. On the contrary, Fotona QX MAX  laser treatment induces collagen synthesis, leading to improvements in dermal layer thickness and collagen fiber density. This effect is well documented in many clinical studies.

How do I take care of the skin after laser treatment for skin pigmentation?

Immediately after treatment, there may be some mild redness of the skin that may persist for a few hours. Do avoid sunlight exposure for at least a month before and after laser treatment and use a sunscreen of at least SPF 25. Occasionally, the treated skin may feel dry – this effect is temporary and it is advisable to use a moisturiser to soothe the skin.

How many Fotona QX MAX treatments are needed ?

Depending on the type of pigmentation, you may need from two to eight treatments to observe significant pigmentation reduction. Each treatment takes about 30 minutes, with no recovery time needed.

Additional Benefits with Fotona QX MAX Laser Treatment

Fotona laser treatment has the added benefit of skin tightening and overall rejuvenation. The laser energy may stimulate collagen synthesis and remodeling, leading to improvements in skin elasticity. In addition, the treatment can also reduce pore size and permanently decrease fine hairs.

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