Melasma

Melasma

The joys of new motherhood aside, there’s one potential side effect of pregnancy most women would likely rather live without: melasma. Thought to be caused by hormonal changes – like those that occur during pregnancy, particularly during the second and third trimesters, or as a result of taking birth control pills or certain other types of medication – melasma may appear as areas of hyperpigmentation, dark skin or discolouration on the face, abdomen or other parts of the body.

Melasma treatment can be effective in the majority of patients. This type of skin pigmentation is more commonly seen during the summer months to its high UV rating. It is a unique form of hormonal pigmentation that is mostly seen in women. Melasma can be improved by up to 80% with a combination of prescription creams, gentle chemical peels and special lasers. Read on to find out why melasma happens and learn about possible melasma treatments at our Clinic.

Before & After Photos

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Frequently asked questions

A consultation with an experienced, professional anti-aging skin specialist will uncover which of the following types of melasma you have, and what the best course of treatment will be:

  • Epidermal melasma: Affects the surface or top layer of the skin, is characterized by well-defined edges or borders and usually responds easily to treatment.
  • Dermal melasma: Affects the second, deeper layer of skin, is characterized by lighter-brown patches with less precise borders and is more difficult to treat.
  • Mixed melasma: A combination of the above two conditions, this variety generally improves with treatment.
  • Chloasma: When melasma occurs during pregnancy, it may be called chloasma or the “mask of pregnancy” and often appears as dark, blotchy, brown patches of skin on the forehead, upper lip and cheeks

Though the exact cause of melasma isn’t known, the dark patches that characterize it could, as mentioned above, be triggered by factors like pregnancy, birth control pills and other meds that make skin more prone to pigmentation after exposure to UV light. A leading trigger for underlying melasma – which you may not even know you have – is considered to be uncontrolled exposure to sunlight, particularly in people (mainly women) with a genetic predisposition to the condition.

Considering the damage that too much exposure to sunlight can do to your skin, your first step towards prevention of melasma is sun avoidance – in other words, cover up with protective clothing, always use a physical sun block and, as much as you can, stay out of the sun for prolonged periods of time. Also wise: getting started on a medical grade skin care system, which includes products that introduce age-appropriate combinations of skin protection and strengthen the skin’s barrier function. Our Bluestone SunShields provides the ultimate protection.

Though it can’t be cured, modern medical approaches have, in recent years, helped patients with melasma see tremendous improvement in their skin. Melasma treatment success is usually achieved through a comprehensive approach that includes suppression and prevention, correction, and ongoing (lifelong) maintenance and management:

  • Suppression and prevention: Achieved with medical-grade skin-care products that may include retinol and lightening agents, the latter of which will lighten only areas of the skin that are hyperpigmented or discoloured/darkened.
  • Correction: A PicoWay Resolve treatment can destroy columns of the pigmented, damaged skin characterized by melasma, allowing it to heal and renew as healthy, non-pigmented skin. Diagnosis via an in-depth skin analysis with one of our experienced medical aesthetician is essential to determining whether use of this powerful tool – or any other type of laser – will be beneficial.
  • Ongoing maintenance: You can help prevent melasma from reappearing through proper prevention, accomplished with the use of a medical-grade sunscreen and a true, physical sun block
  • The cause of melasma is a mix of genetics, UV exposure and hormones
  • This is a special form of pigmentation that presents on the upper lip, around the eyes, and forehead area. Melasma is often patchy, and motley in appearance
  • The majority of melasma can be improved with a combination of clinical chemical peels, medical grade skin care and special lasers
  • The degree of improvement will depend if melasma is epidermal, mixed or dermal.
  • IPL should not be used to treat melasma, as this often can worsen skin pigmentation
  • Lasers such as Clear and Brilliant Permea and PicoWay can improve melasma. We prefer these gentle lasers over Fraxel laser for the treatment of this form of pigmentation
  • Melasma usually returns unless a prevention plan is undertaken after treatment
  • Our melasma prevention plan is a combination of creams, Chemical Peels or Clear+Brilliant lasers with Vitamin A, B, C infusions. Medical grade facials such as SilkPeel Dermalinfusion, and Hydrafacials can also be included in our prevention plan

It is because melasma is a unique form of pigmentation and ‘sun damage’. Unlike other types of pigmentation, melasma has to be treated in a special way, namely to inactivate the pigment producing cells before any peels or laser is performed.

Failure to inactivate pigment cells worsens this condition. IPL should not be used to treat melasma as rebound is seen in nearly all cases. We prefer to use gentle lasers such as PicoWay to treat this unique form of pigmentation.

The optimal melasma treatment will depend on the type of melasma you have. The majority of patients will have mixed melasma- this means your pigmentation lies on the surface as well as deeper in the dermal layers of your skin. The best method of treating this form of melasma is with a combination of creams, gentle chemical peels and laser.

  • Sun protection and sunscreen forms the basis of treatment. If you are sun exposed for 20 minutes without sun block, all the work you may have accomplished to fade your melasma will be undone.
  • Creams- we use a mixture of fading creams, including bleaching agents, Vitamin A, as well as Vitamin C serums.
  • Peels- our favourite peels include AHA or glycolic, or lactic acid peels. TCA at very low concentration can also be used.
  • Lasers- We prefer Picosecond lasers and Clear and Brilliant over Fraxel. However, dermal Melasma can greatly be benefitted from Fraxel.

The best treatment for your melasma will depend on the type of melasma you exhibit, and your skin type (skin colour).

In summary the best treatment for melasma is a regime of –

  • Creams
  • Chemical Peels
  • Laser Program for skin colour, clarity and collagen

This is one of the most common reasons for melasma to worsen. Despite education of aestheticians and cosmetic GPs, IPL is still performed on melasma. In most cases this treatment will worsen melasma. Some cases of epidermal melasma can respond to IPL, but only if the pigment producing cells are kept at bay before treatment.

The reason why IPL worsens melasma is because of the excessive heating of skin with this treatment. IPL stands for intense pulse light. This light is converted to heat energy that in turns stimulates excessive pigmentation. Low level laser on the other hand, decreases the activity of melanocytes, namely addresses one of the causes of melasma.

Yes. There are many papers on melasma treatment  with Fraxel laser, however we try to avoid this treatment IF you have not had medical treatment nor have trialled our other lasers. Here are reasons for holding back on Fraxel-

Yes, but laser melasma treatment has to be gentle and exact for cases of this form of pigmentation. Laser can also be useful for dermal melasma. Unlike IPL, the aim of laser is not to heat up melanocytes (pigment producing cells), but to decrease the transfer of pigment from these cells to the skin. This is a gentle treatment process and takes 5-6 sessions before results can be seen.

High density, but low energy Fraxel can be used to treat melasma, however this laser can also make this condition worse. We only reserve Fraxel for patients who fail the our other corrective Programs or the PicoWay Resolve  laser.

Fractional lasers such as CO2 and Erbium have been reported to improve melasma, however most of these studies are from Korea and Japan- areas where the UV index is much lower. We never treat melasma with ablative lasers as this will always result in rebound pigmentation. Our melasma treatment program spans over 16 weeks.

  1. Not everyone will improve with Fraxel laser. If you have pure sun damage and sun spots, Fraxel is our treatment of choice, but if you exhibit melasma, Fraxel has a chance of making it worse. We do use a less powerful version of Fraxel known a Clear+Brilliant to maintain results following melasma treatment.
  2. All patients who undergo Fraxel MUST be on a fading agent of pigment reegulators. This will reduce the chance of rebound.
  3. All other treatments are far more cost effective than Fraxel. 3-4 Fraxels can cost almost 3 thousand dollars- that is the cost of over 10 peels or nearly a few PicoWay laser treatments. For melasma you may need up to 4-5 Fraxel treatments. We don’t encourage patients spending upwards of 4-5 thousand dollars for results that are not guaranteed.
  4. Fraxel has a downtime of 2-5 days, other treatments do not. Fraxel is the last line in our treatment protocol for melasma.

In summary, Fraxel is an excellent method for treating sun pigmentation, sun spots, and freckles, however we do not always endorse this treatment for melasma – it is however FDA cleared to treat Melasma.

Methods we use to treat

Fraxel laser is one of the best lasers in the World. This laser can be used to treat skin pigmentation, wrinkles, acne scars and sun damage. It will give your skin a whole new texture and brilliance to it. Fraxel laser is gentle on your skin, with a recovery rate of 4-6 days. We recommend 1-5 treatments depending on your skin condition. Fraxel is considered a ‘fractional treatment’, meaning that it creates hundreds of deep columns through the skin called microscopic treatment zones. This means only a percentage of the skin is affected during each laser pass, reducing healing time, promoting natural regeneration of collagen, and rejuvenating skin cells. Due to the fact that Fraxel laser works through non-ablative resurfacing, the epidermis, or top layer of skin, is not directly impacted. As a result, patients can expect faster healing after treatment.
A celeb-fave, PicoWay Resolve has quickly become a go-to treatment for correcting fine lines and wrinkles, and improving skin’s texture and tone. The precise heat of the laser stimulates collagen production without damaging surrounding tissues. With virtually no downtime, it’s also more comfortable than more ablative lasers. If you struggle with hard-to-treat melasma, you know this pesky condition cannot be prevented. PicoWay Resolve is one of the fastest and most effective melasma treatments available, often boasting results in just a few treatments.
In the world of earthy purifying wonders, charcoal is right up there with clay and mud. It’s been called the holy-grail ingredient and has been purging impurities since ancient times, thanks to its ability to attach to and absorb toxins. ​ In the past few years, charcoal has exploded in the world of skincare. Activated charcoal draws bacteria, poisons, chemicals, dirt and other micro-particles to the surface of skin, helping you to achieve a flawless complexion and fight acne. V Carbon Peel is a unique non-invasive treatment uses activated charcoal for an exfoliating and purifying effect that enhances facial lifting by penetrating deep into the pores. It’s the ideal system for tightening dilated pores and removing dead cells from the superficial epidermal layer for an overall new look. V-Carbon allows to make medium or deep peeling treatments depending on the patient’s needs.
The AFA peel is a type of chemical peel that has become an essential part of many men and women’s skincare regimen. AFA stands for Amino acid Filaggrin. It is an antioxidant that works to retain the moisture in your skin, leaving it looking fresh, renewed, and hydrated. AFA peels are also acidic. They work as effective exfoliants yet cause minimal irritation to the skin because they are made from the same type of amino acids found in the body. The AFA peel is actually one of the few chemical peels that do not make your skin sun-sensitive, making it the perfect option for all skin types.
The AFA peel is a type of chemical peel that has become an essential part of many men and women’s skincare regimen. AFA stands for Amino acid Filaggrin. It is an antioxidant that works to retain the moisture in your skin, leaving it looking fresh, renewed, and hydrated. AFA peels are also acidic. They work as effective exfoliants yet cause minimal irritation to the skin because they are made from the same type of amino acids found in the body. The AFA peel is actually one of the few chemical peels that do not make your skin sun-sensitive, making it the perfect option for all skin types.
Younger patients are focusing on prevention and are more and more curious about how they can combat the development of lines and wrinkles. Whether you just noticed your first crease, want to be proactive about the aging process, or just want a gentle, yet effective, laser resurfacing treatment, Clear & Brilliant is your perfect treatment. Designed with a powerfully precise laser energy to stimulate collagen, Clear & Brilliant quickly and effectively treats the signs of aging to reveal more youthful looking skin
Resurfacing refers to the ablation or removal of skin tissue so new healthy tissue can be formed. Fractional skin resurfacing means that specific small areas, a fraction of the skin’s surface, are removed in a precise pattern leaving the surrounding healthy skin intact. The small sections of untreated healthy skin that are left intact facilitate rapid healing of the treated areas, resulting in very high patient satisfaction. EndyMed’s unique 3DEEP® technology signifies a new era in anti-wrinkle and skin tightening technology. It is clinically proven to deliver tighter, firmer, lifted skin, safely and effectively with little to no downtime.
During this procedure, tiny needles are used to create controlled micro-injuries to the skin in order to produce collagen and elastin, the cornerstones of healthy, firm, smooth skin. eDermastamp also creates superficial micro-channels which allow topical serums to be absorbed more effectively into the skin. The benefits of microneedling are a reduction in the appearance of fine lines and wrinkles as well as younger-looking skin with fewer signs of aging. eDermastamp also has a positive effect on hyperpigmentation, hypopigmentation, acne scars, traumatic scars, and stretch marks and generally creates a fresher appearance or glow to the skin.
The key to optimal skin health is a skincare professional. By combining a customized at-home regimen with powerful in-office treatments and targeted skincare solutions, the result is healthier skin with visible improvement in fine lines, wrinkles, and other signs of premature aging. At LSG we offer SkinCeuticals skincare products. SkinCeuticals is an advanced clinical skincare line that offers comprehensive formulas to correct signs of aging, promote healthy skin, and prevent skin damage. Ranging from anti-aging moisturizers and eye creams to acne cleansers, vitamin C serums, and retinol products, our advanced skincare products are backed by science. Physicians and skincare professionals define cosmeceuticals as products on the cutting-edge between cosmetics and pharmaceuticals. Active ingredients in cosmeceuticals are expected to be clinically proven to enhance skincare efficacy.
Broadband light technology generates broad-spectrum light waves that penetrate deeply into the lower layers of your skin. The light is changed to heat energy as it reaches beneath the surface of the skin. As this special type of light saturates the epidermis, chemicals in your skin change light energy to beneficial heat energy that immediately begins repairing damaged skin by stimulating collagen production. Collagen is a protein-rich, structural compound necessary for supporting all your body’s tissues. It is also essential for providing firmness, suppleness and strength to your facial skin. Skin naturally produces less and less collagen as we age, a major contributing factor to wrinkling, sagging, dryness, and unattractive spider veins.
Every once in a while a treatment is introduced that takes us one step closer to the fountain of youth. The Forever Young BBL Photo-Facial is a big step in that direction and is one of the most advanced techniques available today to slow down, treat and reverse damaged and aged facial and non-facial skin.  This is the most effective and advanced form of photo-facial and photo-rejuvenation currently available due to the broadband light technology. The Forever Young BBL encompasses all of the advantages of the original BBL Photo-Facial procedure along with the newly recognized benefit of delaying skin aging. The treatment targets hyperpigmentation, sun damage, broken capillaries and diffused redness in the skin all while stimulating collagen. Forever Young BBL clients have seen great results on the face, neck, chest, hands, arms and other body parts.
DMK believes in Natural, Non-Invasive and Pain Free solutions to skin conditions and age management. DMK formulations are botanical based & pharmaceutical grade because this ensures that our product contains enough of an ingredient to experience significant visible results. Pharmaceutical grade means less than 0.1% impurities in DMK formulations. Great skin doesn't happen with one product or one treatment but if your consistent with your routine and realistic about your expectations DMK can really make a difference. DMK Enzyme Therapy is a hard setting face and body mask that is applied from the décolletage, up the neck and over the face. The mask contains living enzymes that stimulate our own natural enzymes to speed up cellular processes within the skin.
14% Salicylic Acid, 14% Lactic Acid, 14% Resorcinol. The Jessner peel is a highly concentrated medium to deep peel that works effectively on all skin types. This treatment aggressively targets hyperpigmentation, sun damage and scarring, while minimizing fine lines, reducing pores and tightening the skin to create a smooth, even texture. Jessner is also proven to be highly effective at targeting acne and rosacea type breakouts. Immediately after your first treatment, you will notice a progressive difference in your complexion, with a radiant, healthy and refreshed appearance.

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