Melasma treatment that works

Article medically reviewed by Dr. Gavin Chan

Templestowe Lower, Berwick and Beaumaris Clinics

Dr. Gavin Chan, MBBS, General Registration (MED0001175745), founder of the Victorian Cosmetic Institute, began offering cosmetic medical treatments in 2004. Formerly a trainer for cosmetic pharmaceutical companies, Dr. Chan currently concentrates on offering ongoing training to cosmetic doctors at the Victorian Cosmetic Institute. He ensures that all doctors stay updated with the latest procedures and methods in the cosmetic industry. Read More

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Melasma is a patchy, dark skin pigmentation that primarily occurs between the brows, on the forehead, around the cheeks and above the upper lip. Typically only affecting the face it can be distinguished from other forms of skin pigmentation because of its slightly asymmetrical and patchy pattern. According to Dr Gavin Chan (MBBS, Cosmetic Doctor, Liposuctionist) “Melasma is a hyperpigmentation problem which is driven by the hormone oestrogen and UV radiation. It mainly affects women who have olive or darker skins. Typically we see melasma in patients who have Asian, Indian or European backgrounds.”

He notes that melasma can be a difficult type of skin pigmentation to treat without well-trained and experienced professional help from Cosmetic Doctors and Cosmetic Nurses.

Melasma occurs as a result of the overproduction of melanin by melanocytes (pigment cells). This is removed up by the keratinocytes and deposited in the skin. The causes of melasma are very complex. While there is some genetic predisposition to melasma, it can also be triggered by sun exposure and sun damage.

Other melasma triggers can include:

• Pregnancy
• Hormone treatments including HRT, intrauterine devices and implants and oral contraceptive pills containing oestrogen and/or progesterone
• Medications
• Scented soaps, toiletries or cosmetics can cause a phototoxic reaction resulting in melasma

Why do women get melasma more than men?

Because the hormone oestrogen influences melasma, more women than men are affected by it. Dr Gavin Chan notes that melasma can be of concern for women. While skin pigmentation can be covered with make up, many women would prefer not to do this.

Before you commence any melasma treatment it is important for the Cosmetic Doctor to determine if there are any reasons why the skin pigmentation has increased. When women take the contraceptive pill, it adds another form of external oestrogen, which can exacerbate the melasma. In some cases using a different brand of contraceptive pill with low dose oestrogen or progesterone only option can reduce skin pigmentation.

Women who are pregnant can develop brown, dark blotchy patches of skin on their forehead, cheeks and upper lips. This type of melasma is called chloasma (sometimes called the “mask of pregnancy”). It is not appropriate to treat melasma with skin treatments if you are pregnant or breastfeeding. We advise our pregnant and breastfeeding patients to take preventative measures that include using sunscreen and wearing a hat.

Some women who are on hormone replacement therapy (HRT) can develop melasma. A preventative approach combined with our melasma treatments can help treat and reduce this.

Are there any topical solutions that can reduce melasma?

Dr Gavin Chan notes that exposure to the sun and UV radiation activates the melanocytes to create more melanin which deepens skin pigmentation. “If you have melasma you need to take particular care to avoid sun on the face and to use the highest SPF sunscreens every day. We recommend the most important part is to be consistent and use SPF50 sunscreens daily, even if it’s raining or overcast.”

Applying a couple of layers of sunscreen on your face and body ensures you have full SPF protection. This will help reduce your skin pigmentation and help prevent premature ageing of your skin.

Dr Gavin Chan also recommends that using serums and creams, which inhibit Tyrosinase can also reduce melasma. The copper-containing enzyme Tyrosinase blocks the production of new melanin, which results in skin pigmentation.

Using topical retinoids (Vitamin A) is another common topical solution that reduces melasma. The additional benefit of using topical retinoids is they increase the turnover of your skin cells, making your skin look and act younger. Topical retinoids are proven to reduce fine lines and wrinkles.

Another topical option to reduce melasma is for a Cosmetic Doctor to prescribe a Kligman’s formula prescription skin lightening topical treatment. Containing hydroquinone, dexamethasone and tretinoin this effective treatment has minimal adverse side effects. It’s important to note that this is not an appropriate melasma treatment if you are pregnant or breastfeeding.

According to Dr Gavin Chan another way to treat melasma is to use an occasional light chemical peel. A chemical peel exfoliates the skin and removes any excess skin pigmentation and melanin. His team of highly trained and experienced Cosmetic Doctors, Cosmetic Nurses and Skin Therapists prefer to use lactic peels because they are tolerated well by most skin types.

Can laser treatment be used to treat melasma?

While laser treatment is very effective at flushing out the existing melanin and reducing skin pigmentation, Dr Gavin Chan explains that it has to be used very carefully.

“Because we mainly treat melasma patients who have olive or darker skin types it can be much more difficult to treat with laser. There is a lot of competing melanin naturally found in normal skin so with laser we only use very light laser treatments to avoid flaring up the pigmentation. If we believe laser treatment is an appropriate melasma treatment we usually use Q switch. Q switch lasers have very short pulses that go into the skin and break down the pigment to cause the skin to turnover. In some cases we will use Fraxel lasers“

Fraxel lasers effectively reduce skin pigmentation and wrinkles while improving the skin tone and texture.

What is the best oral solution to treat and improve melasma?

Dr Gavin Chan and his team have successfully treated with melasma by using the oral medication Tranexemic Acid. While this has been traditionally used to stop bleeding, in small dosages twice a day it blocks the production of melanin in response to UV radiation.

Dr Gavin Chan notes that another effective treatment that is not as convenient is to have intravenous vitamin C and an antioxidant we cannot name due to TGA regulations. “We often successfully treat people using this method. The downside of this treatment is having a session of intravenous therapy every week at the clinic. The upside is a reduction of skin pigmentation and brighter and lighter skin.”

The best skincare to use to improve your melasma

Using the right skincare to treat and reduce your melasma is important. Dermaceutic 21 Day All Things Pigment Kit reduces skin pigmentation, spots and inflammation. It has been designed to maintain the results of professional Dermaceutic Peels. Products in the Homecare Kit include:

• Dermaceutic Foamer 15 (100ml): The combination of Glycolic acid, Enoxolone, Vegetable glycerine and Quaternised foaming coconut oil remove dead skin cells and impurities to leave your skin silky smooth.
• Dermaceutic C25 Cream (30ml): The rich antioxidant concentrate with over 25% stable Vitamin C combats free radicals while smoothing out the complexion of your skin.
• Dermaceutic K-Ceutic SPF 50 (30ml): With K Complex (a highly effective tissue repairer) and SPF50, this cream nourishes and protects your skin. Recommended for use after cosmetic or laser surgery.
• Dermaceutic Mela Cream (30ml): The combination of 8 highly active ingredients reduces skin pigmentation and melasma while inhibiting the transfer of melanin. As one of the strongest depigmentation creams available, your skin improves and becomes brighter and clearer.

Dermaceutic Mela Cream has been created to significantly decrease the appearance of dark spots, regulate pigment production and even out skin tone. The powerful and highly concentrated active ingredients including pH4.27, Kojic, Salicylic, Phytic and Mandelic acids, Arbutin, Niacinamide, Retinol and Liquorice Extract inhibit the transfer of melanin resulting in reduced skin pigmentation.

Not sure which skincare is best to treat your melasma? A skin consultation with highly qualified and trained Skin Therapists with experience in treating melasma will ensure your skincare gives you the best results. Book your skin consultation on 1300 863 824.

Where to get the best melasma treatment in Melbourne

Since 2005, led by Dr Gavin Chan our highly trained and experienced Cosmetic Doctors, Cosmetic Nurses and Skin Therapists have helped thousands of people with melasma treatments. It’s important to note that melasma treatments are not a quick fix. To get optimal results a multiple modality approach is usually required. This may include oral and topical prescriptions, chemical peels or laser treatments.

Find out how we can treat and reduce your melasma. Call us on 1300 863 824 or book your consultation online.