I am Dr. Mohna Chauhan. I am MD in dermatology and I'm practicing in Noida.
Today I'll be talking about an entity called facial melanosis. Melanosis basically stands for the presence of abnormal Melanin pigment deposited in this skin, when it is present mainly in the face, it is termed as facial melanosis. Now facial melanosis can be because of various causes and few of these I will discuss.
First, it can be from tanning, it can be because of melasma which is often related to pregnancy, hormone imbalance and stress, it can also be because of Vitamin B12 deficiency. Facial melanosis is also seen in some conditions like acanthosis nigricans which is often seen in diabetic and hormonally imbalanced patients. It can also be as a result of hair dye, where patients are allergic to hair dye and it leads to pigmentation on the face, it can also be because of some other sun damage like freckles and lentigines and finally some rare causes like lichen planus pigmentosus which leads to pigmentation on the face and other areas.
Now, it is important to know that pigmentation can be very superficial, deep or both superficial and deep. Now we will discuss some treatment aspects of treating facial melanosis.
The most important aspect of treating facial melanosis is the use of the right sunscreen. Now, it should be a medicated pharmaceutical sunscreen which should preferably have both chemical and physical blockers. Sunscreen should ideally be repeated every three hours because the best of sunscreens also get inactivated after 3 hours.It should be ideally applied in the morning so repeat it twice in the afternoon. Now, apart from sunscreen another very important aspect of sun protection and photo protection is physical blockage wear goggles, use of cap, use of hat, use of a scarf all these are encouraged. On a sunny day it is always advisable to take an umbrella whenever possible.
Now other aspects of treatment apart from good sun protection is cream based treatments, a lot of Vitamin C based serums and creams are really helpful in controlling the sun damage. Facial melanosis also requires some special medications in some cases like for lichen planus pigmentosus we need proper medical intervention. Other deep pigmenting agents like hydroquinone, kojic acid based creams are also very important and should preferably be used at night time for best results.
Apart from creams and serums that can be applied at home sometimes we require oral medications as well, commonly prescribed medications are oral vitamin C, oral glutathione, oral tranexamic acid as well as in some cases oral isotretinoin.
Now apart from medications both to apply and to eat there are some procedures which are done by the dermatologists that helped a lot in treating facial melanosis. The first one out of these is chemical peeling, chemical peel is basically a liquid medicine or a cream based medicine of high concentration which is applied on your skin by the dermatologist for a controlled period of time often one session is done every two to three weeks and after four to six sessions you see an adequately good result which is appreciable; of course, sun protection becomes extremely important while you're on such procedures.
Apart from chemical peeling which is an FDA approved treatment for treating facial melanosis. In some cases, lasers are also done, the gold standard laser for pigmentation is Q-switch NdYAG laser, which is a non-ablative painless laser done for your face to treat various conditions like melasma, sun spots as well as other disorders like lichen planus pigmentosus. Lasers are often done only by dermatologists and lead to good results after four to six sessions, again sun protection becomes extremely important to preserve the results that we have achieved.
After lasers other therapies with benefits are mesotherapy where tiny injections are given into the skin of vitamin C, glutathione etc and these are painless and give a very good result in terms of glow and reduction in pigmentation. These are also done every month or every three weeks. Apart from this some ablative lasers like carbon dioxide laser or erbium YAG laser and in some cases non-ablative lasers like erbium glass laser can also be done for giving improvement in facial melanosis.
A treatment plan has to be made out individualized for each patient depending upon their cause, of course if there are some vitamin deficiencies like vitamin B12 deficiency these have to be replenished. Now if facial melanosis is because of acanthosis nigricans then controlling your weight and controlling the hormonal imbalance will also help in improvement along with medical treatment. If facial melanosis is because of the pigmentation from allergy to hair dye, such hair dye usage should be discouraged which will result in better treatment outcome.