Melasma is a common skin disorder characterized by dark facial skin with irregular borders. It is usually found on the cheeks, lips, forehead or nose and is seen in all skin types. People with higher concentrations of melanin in the skin are more prone to developing melasma. Various treatments are available and doctors have found that laser treatment is effective in addressing melasma.
Melasma is caused by an increase in the production of melanin, the substance that gives skin its color. The exact cause of this hyper-pigmentation is unknown, but the top four factors that contribute to melasma are genetics, hormones, sun exposure and skin inflammation. Intense or chronic sun exposure can make the problem worse. Menopause and pregnancy can also trigger melasma. In fact, it is so common among pregnant women that it is known as "the mask of pregnancy."
Who Is Affected
Melasma affects mostly women, and is more common among people with darker skin tones. The majority of cases are seen during pregnancy or among women who take birth control or hormone replacement drugs. Melasma also seems to have a genetic component. If your mother or grandmother is affected, you are more likely to have this skin condition as well. Men can develop melasma, but it is rare.
There are three distinct types of melasma: epidermal, dermal and mixed. Epidermal melasma occurs close to the skin's surface and is fairly easy to control. Dermal melasma occurs deeper in the layers of skin and is more difficult to treat. Mixed is when a combination of the two types are present. Your doctor will be able to diagnose your type of melasma by looking at your skin or using a special light called a Woods lamp.
Resurfacing and YAG Laser Treatment
Resurfacing laser treatments penetrate deep into the skin with columns of microscopic light to eliminate the cells that cause melasma. The YAG laser delivers short, intense pulses of light targeted to the melanin in the cells affected by melasma. The laser has no effect on the surrounding skin. The laser treatments are given monthly for a three to four month period, along with topical lightening treatments that are used for a few weeks prior to the laser treatments and continue after laser treatments have been completed.
Intense Pulsed Light Treatment
During intense pulsed light (IPL) treatment, a hand-held laser is passed over the skin to target the melanin. IPL treatment has been shown to work best with epidermal type melasma. The light energy heats the melanin cells to destroy them. While IPL is an effective treatment for melasma, be sure to consult with your doctor to determine your type of melasma and whether IPL is right for you.
What to Expect From Laser or IPL Treatment
If you decide on laser treatment, choose an experienced physician. Your doctor will analyze your skin to determine your best course of treatment. Your face will be cleansed and a topical anesthetic will be applied to the skin for about 45 minutes. The laser will be passed over the skin in the specific treatment areas. The cooling technology of the laser will minimize any discomfort of the treatment. With IPL treatment, a topical anesthetic is not usually applied. You and your doctor will wear protective eyewear to protect your eyes from the laser light. After treatment, you can expect your skin to feel similar to a sunburn and may bruise or peel. Avoid sun exposure after treatment. Your will need a series of treatments to address the problem of melasma. Your doctor will discuss with you how many treatments your skin will need.
Moisturizers and sunscreen are a post-treatment must. As your skin heals you may experience some bronzing of the area as the skin rebuilds. Follow the advice of your doctor for follow-up visits and other post-treatment recommendations. A sunscreen with an SPF of 30 to 60 is recommended directly after treatment. Sun damage is the primary contributor to melasma, so no matter what your skin type, always use sunscreen.