Melasma and it's Management

Melasma is one of the most common forms of hyperpigmentation .It commonly appears as brow or gray -brown patches on the face . These patches are usually symmetrical and visible on cheeks,forehead,bridges of nose,above the uper lip and chin .

CAUSES OF MELASMA

Melasma is more common in women than men.

1) Sunexposure

2) A change of hormonal level ( pregnancy)

TREATMENT OF MELASMA

1} Sunprotection -is the key factor for decreasing melasma.

2} Depigmenting agents

a} Hydroquinone- the most common used agent ,works to inhibit a melanin -producing enzyme . It has potent antioxidant abilities.Topical hydroquinone creams comes in 2% and 4% concentrations alone or with tretinoin.Creams containing hydroquinone is intended for short-term use. A dermatologist recommendation is very important .

b} Arbutin -natural source of hydroquinone ,is considered to be much safer . It is dervided from the leaves of bearberry,cranberry,mulberry or blueberry shrubs .It too has the ability to ihibit melanin production.

To enhance skin-lightening ,the following ingredients may also help .

• Retinoic acid
• Azelaic acid
• Kojic acid
• Glycolic acid
• Low mid-potency steroids

Pocedures fr Melasma

Chemical peels - eg. glycolic acid ,tricholroacetic acid )work well in treatment of melasma . These exfoliate the superfical layers of the skin and increase the cell turnover,which triggers the fading of unwanted pigmentation . The number of sessions depend on the level of pigmentation and skin sensitvity.

Lasers- escpecially the Q-switched Nd:YAG laser ,have a positive effect on early melasma . These are also relatively safe o Indian skin.The laser light beam acts on the pigment(melanin) clumps within the skin and fragments them.Once fragmented ,these are easily cleared by body's immune system . It is done in a gap f 15 to 20 days for a minimum of 8 to 10 sessions.