What is Melasma?
It is a pigmentary condition that affects females more commonly. It is especially common in Singapore due to ample ultraviolet rays. It can affect any part of the face but most often in the central area of the face (up to 80%), followed by the cheeks then the chin area. It is also possible to acquire it on the neck, arms and legs.
The management of this condition remains challenging to treat since we do not fully understand how it develops and its high recurrence rate.
It is common amongst Asian women, Japanese, Koreans, Chinese, South East Asian origins.
They usually present as symmetrical patches over the high areas of the cheeks with irregular borders. When looked under the microscope melasma pigments can be seen at various different layers of the skin.
What causes Melasma?
To tackle this disorder effectively, it is essential to understand how it comes about.
- UV light
- Family History
UV is one of the most prominent triggers of Melasma shown in both clinical and laboratory studies. New studies suggest that thermal energy, such as heat could exacerbate Melasma. So my suggestion is a copious sunblock and a trusty hat with a wide brim.
Treatment of Melasma is not straightforward, and it is essential that you seek an experienced doctor to treat and the course of treatment is long-term.
Studies have shown that 54-64% of patients with Melasma have a positive family history. Unfortunately, this is something that we have no control over.
Melasma worsens with pregnancy, oral contraceptive pills, hormonal therapies and menopause, change in environment, general aging or degeneration of skin’s health.
How to treat it?
Active ingredients such as arbutin, glutathione, tranexamic acid, kojic acid, azelaic acid, hydroquinone, corticosteroids are skin lightening agents that can help with Melasma. The problem is that the side effects are often hard to bear. Most of the high strength topical agents would cause skin redness and irritation. Prolonged use of corticosteroids can cause telangiectasia, epidermal atrophy. Speak to TM Beauty angels to find out more information about the latest product available, we recommend to try before purchasing.
Triluma– contains Corticosteroids, Hydroquinone, and tretinoin.
Oral therapies are emerging as an additional treatment option, on top of procedures and topicals. Tranexamic acid has been found to reduce melanocytes stimulation hormones (MSH) and Vascular endothelial growth factor (VEGF). Results have been promising with a study showing 90% success after 2-6 months. Some of the side effects to note are abdominal bloating, headaches, menstrual irregularities, deep vein thrombosis (DVT)
Oral supplements such as Polypodium leucotomos (PL), Heliocare, have been shown in studies to have positive results. It can decrease UV-induced photodamage and reduce oxidative stress. Basically, it makes the skin more resilient to UV damage. There is no reason to not take this amazing supplement to better skin health.
- Chemical Peels
- Tailored Skin-booster Injections (Prescriptive active ingredient- only available in Clinics)
Chemical peels, using agents such as glycolic acid (AHA)or Jessner’s solution, increase skin remodelling and turnover rate. Studies have shown that repeated 3-week intervals for six months have resulted in satisfactory results in people with Melasma compared to just topical azelaic acid application. A chemical peel is useful for pigments that are generally on the superficial surface. For more stubborn pigments that are laid deeper, laser treatment recommended.
Non-ablative Q-switched lasers, such as neodymium:yttrium-aluminium-garnet, or picosecond lasers at TM Medical have been found in studies to have a long-term benefit in treating Melasma. Results improve with the combination of IPL treatment. Lasers recommended since it is well tolerated with minimal skin irritation and redness and its effects remain for the long-term. Results are more effective with the concurrent use of sun protection, topicals and oral.