Melasma / Chloasma: Melasma Info, Causes & Treatments: Melbourne

Quick Facts

  • Melasma is a form of pigmentation stimulated by oestrogen and UV exposure
  • It appears as brown-grey patches on the cheeks, upper lip, between the brows, and forehead.
  • Underlying causes of melasma, such as the oral contraceptive pill, need to be addressed firstly
  • Sunscreens, lightening agents, laser treatments and chemical peels can be used to treat melasma
  • If treated inappropriately, melasma can actually worsen.

What is melasma?

Melasma, also known as chloasma, is a form of pigmentation that is stimulated by oestrogen - either from pregnancy, the pill, hormone replacement therapy or normal circulating oestrogens,  and is a difficult form of pigmentation to treat. As a result, melasma mostly affects women, although it can occur uncommonly in men. It appears as large brown-grey patches on the face. It is usually located on the cheeks, upper lip, betwen the brows, or on the forehead. Most people who are affected by melasma tend to have a more olive or dark complexion. Melasma can never really be cured, but it can be treated to minimise its effect.

What causes melasma?

It is important to try to determine if there are any causative factors that may be exacerbating the pigmentation, for example, the oral contraceptive pill.

The next step is daily sun protection, and this is paramount in the treatment of melasma. UV radiation is a key factor that exacerbates melasma, and often those affected with melasma first notice it appear during or after a summer where they have had significant UV exposure.

The mainstay of treatment is a topical lightening agent. Kligman's formula is often recommended, as it is a powerful combination of lightening and exfoliating agents to help lighten skin pigmentation. Kligman's formula is prescribed by our doctors. It contains hydroquinone, which helps to prevent the production of melanin, tretinoin/retinoic acid which helps to exfoliate and flush out exisiting melanin, and hydrocortisone, which helps to calm the skin from these active ingredients.

The Medlite laser can help reduce melasma, through weekly to fortnightly treatments for 6 to 8 sessions. The Medlite laser works by being selectively attracted to the pigmentation over normal skin. It also has very short pulses (as short as one billionth of a second) which helps to shatter the pigmentation.  The downtime is minimal per treatment, there is usually some mild darkening of the pigmentation that lasts for one to two weeks, mild redness, and a mild flaking after the treatment. Generally, most people go back to work the day after treatment.

Other lasers or IPL are often used in the treatment of melasma, however, they are often unsuited to this treatment, and cause worsening of the pigmentation. This occurs when excessive heat/energy is transferred to the skin by the laser/IPL and this causes inflammation which leads to the formation of extra pigmentation.  The Medlite q-switched laser has extremely short pulses which deliver minimal heat energy to the skin, and therefore have more of a mechanical effect on the pigmentation rather than a heating effect on the pigmentation. This mechanical effect allows the breakdown of pigmentation without heating the skin and worsening of the pigmentation.

Finally, chemical peels can help speed the process of improvement from melasma by helping with skin turnover, and by helping to shift the melanin deposits from the affected area. Usually light chemical peels are used, as stronger chemical peels can often stimulate new pigmentation production.

 

Melasma case study 1

This patient presents with melasma over her cheeks, chin, and forehead. She also has some acne present. Normally, she wears sunscreen daily, and is careful to avoid excessive sun exposure. The 'after' photos are the result of one month's treatment with Kligman's formula. Note the improvement in the melasma/pigmentation in all areas. Also of note is the improvement in acne, which is most likely due to the retinoic acid present in Kligman's formula. Retinoic acid can help to exfoliate the skin and improve acne.













Melasma case study 2

This is a before and after picture of a female with melasma on her upper lip that was treated for 6 months with Kligman's formula only.

skin pigmentation case study


Melasma case study 3

This was a 40 year old female of indian origin who presented with melasma affecting both cheeks. She was treated for 2 months with Kligman's formula and weekly Medlite laser treatments at 1064nm. There was considerable improvement in the pigmentation, and she also experienced an improvment in the skin texture and smoothness as a result of the laser treatments.

skin pigmentation case study

skin pigmentation case study

Why choose The Victorian Cosmetic Institute as your provider of melasma treatments?

Melasma is a difficult condition to treat, and treated improperly, can often be made worse.  At The Victorian Cosmetic Institute, we specialise in the treatment of pigmentation problems such as melasma, and we have access to a wide range of treatment modalities, including prescription lightening creams, lasers and chemical peels.

Making that first phone call about any cosmetic procedure can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.

It's as easy as clicking either of the buttons below and completing the provided form.

Otherwise, you can phone us directly on (03) 8850 0655 (Templestowe) or (03) 9707 0888 (Berwick).
 

 




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