Description

Melasma or chloasma (also called "pregnancy mask") is an excessive pigmentation of the skin caused by hormonal changes and sun exposure.

Deep and localised pigmented lesions have an intense, dark coloring, and are quite difficult to hide with makeup.

Origins

Excessive production of melanin causes pigmented lesions.

Womenare most prone to melasma, due to pregnancy hormones.

Local hyperpigmentation can also occur following surgical or medical procedures or be caused by use of perfume or aftershave before sun exposure (typically in the neck).

What is melasma like?

At first, melasma may ressemble slightly more tanned area than the rest of the skin, intensifying as years go by, especially in case of insufficient sun protection. Dark spots may be brown or blueish/gray, with irregular contours.

Melasma manifests on skin areas often exposed to sun : cleavage, forehead, temples, cheeks, upper lip.

Medical treatment

Aesthetic medicin offers two efficient procedures against melasma:
- Fractional Laser 15 mm renewing deep skin cells whilst leaving superficial skin intact
- TCA peelings au TCA, by which a thin, superficial layer of skin is replaced by new skin with fewer wrinkles or pigments.We are against abrasive lasers for melasma, due to their excessive agression of the skin.

After medical treatment

Any medical treatment of pigmented lesions must be supported by daily use of an excellentsunscreen.

Skin has a "memory", thus even after extensive treatment of hyperpigmentation, your skin may retain a pattern of producing excessive melanin even in case of little sun exposure. In other terms, you will need to be very careful, even after treatment is completed, preferring hat and/or tents to direct sunlight, never forgetting to wear appropriate sunscreen all year round, so as to avoir recurring melasma.

Bleaching Creams

Prescribed depigmenting formulas can work on fairly recent pigmented spots: Klingman depigmenting trio (hydroquinone, tretinoic acid (vitamin A acid), hydrocortisone); Azelaic acid DCI; Rucinol, etc.

But you should be extremely careful with these creams and apply them only on the hyperpigmented area, at the risk of lightening the skin around the lesion thus increasing the spots' visibility (contrast between normal skin and dark spots surrounded by bleached skin).

Moreover, these treatments require a long time to take effect (6 months minimum), strongly irritate the skin and do not always suffice.It is not uncommon for patients, disappointed with depigmenting creams, to turn to us for a laser treatment and peelings to erase these creams' side effects and finally obtain the result they hoped for.