Melasma: An Ongoing Battle For Many Women

What is it? Melasma (muh-LAZ-muh) is a common skin condition that causes brown to gray-brown patches on the face. It usually presents on the cheeks, bridge of their nose, forehead, chin, and above the upper lip. While melasma does not cause any physical symptoms, melasma causs the skin to look blotchy and uneven. 

What causes it? Women are far more likely than men to get melasma, It is so common during pregnancy often referred to as the pregnancy mask. Hormones, birth control pills and hormone replacement therapy can trigger melasma. Melasma is considered genetic and people with skin of color are more prone to melasma because they have more active melanocytes than those with light skin.  Melasma can fade on its own when its caused by hormonal shifts such as a pregnancy or birth control pills. When a woman delivers her baby or stops taking the birth control pills, the melasma may fade. To help prevent melasma from returning sunscreen must be worn every day and reapplied every 2 hours, in addition to a wide-brimmed hat worn every day. 

Treatment: When melasma lingers and requires treatment the individual has the following options;

* Hydroquinone: This medicine is a common first treatment for melasma. It is applied to the skin and works by lightening the skin over time.

* Tretinoin and corticosteroids:. Sometimes a medicine contains 3 medicines (hydroquinone, tretinoin, and a corticosteroid) in 1 cream. This is known as the brandname triluma.  

*  Azelaic acid or Kojic acid can help "naturally" lighten melasma

*  If a topical medicine does not clear or lighten your melasma, a Chemical peels may be the best option.. 

While all of the former options can be successful in clearing Melasma, my choice is a prescription strength treatment called the Cosmelan chemical peel. This treatment is a two-step process where the peel is applied in office and is then washed off at home after the product is worn for several hours. Once the product is removed, a secondary cream is applied to protect new skin growth. A cosmelan peel differs from other skin brightening products and chemical peels in its ingredients, which are designed to treat the specific symptoms of melasma. This type of peel may be beneficial to those who have tried creams that contain hydroquinone or tretinoin in the past and suffered adverse reactions to these harsh ingredients. The cosmelan peel contains azelaic acid, which kills bacteria on the surface of the skin and boosts new skin cell production; and kojic acid, which is an acid that is derived from several different types of naturally-existing fungi and which inhibits the production of melanin in the skin. There is an at home post peel regimen that needs to be strictly followed. 

After your melasma clears, you may need to keep treating your skin with maintenance therapy to  prevent it from returning. Also daily SPF and hats are essential to the success of keeping it at bay. 

references: 

http://www.melasmadiaries.com/cosmelan-melasma

• - See more at: https://www.aad.org/public/diseases/color-problems/melasma#treatment

- See more at: https://www.aad.org/public/diseases/color-problems/melasma#causes

- See more at: https://www.aad.org/public/diseases/color-problems/melasma#symptoms

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