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Melasma Treatment Brisbane

settle your melasma with creams, peels & laser

Melasma treatment requires a combination of approaches including peels, melasma cream and sometimes laser treatment.  Melasma is a  tricky pigmentation to treat and can never be ‘cured’. However, there are treatment options that can lighten it and keep it at bay. Chloasma is a pregnancy pigmentation that develops by the same mechanism. It is also called the pregnancy mask. The treatment of chloasma varies slightly and a wait and see approach can be adopted in the early stages. Finally understanding melasma causes is vital to prevent recurrence.

The Top 5  Melasma Treatment

  1. prescription hydroquinone or other ‘bleaching’ topical creams
  2. chemical peels, jessner, TCA, vitamin A, superficial glycolic or BHA
  3. Topical Vitamin A
  4.  Sunscreen
  5. Laser Pigmentation Removal

Bleach Peel Melasma Treatment & Other Options

Hyperpigmentation not only impacts on the aesthetic appearance but also has a significant psychological impact on esteem. It is a challenging condition to treat. Though there is no cure as such for melasma or chloasma, there are effective treatment approaches to fade the pigment. Melasma treatment must always consider ongoing care to prevent recurrence and often intermittent treatment to keep it under control.

Multi-stream approach to Melasma Treatment.

Melasma treatment requires combination treatment as well as measures to prevent its return. There are well-established treatments that are effective for fading melasma. However, melasma treatment varies depending on the type of hyperpigmentation and your skin.

Bleach Peel  Melasma Treatment

Bleach peeling * refers to a combination of prescription hydroquinone, prescription vitamin A and with series of skin peels. These remain the standard treatment of melasma. It is not suitable for everyone and not sufficient for all types of hyperpigmentation but the majority of presentations it is an effective melasma treatment.

The bleach peel treatment must be complemented with sun protection & home skin care that satisfies two criteria. Firstly that it does not aggravate the skin &  secondly helps settle inflammation. Melasma cream works through one of the pathways to assist the hydroquinone and peels in reducing hyperpigmentation.

  • Useful for the majority of superficial (epidermal) pigment, limited effect on deep (dermal) pigment.
  • Suitable skin type 1 – 4

The Bleach peel term was first described by Dr Sabine Zenker a German Cosmetic Physician, who became interested in researching melasma treatment because she has the condition.

Alternate Melasma Treatment:

  1. Bleach laser – for treatment of deep pigment. We always recommend starting with the bleach peeling regime first. This has two advantages. Firstly it fades any superficial melasma so that laser treatment can be more targeted. Secondly commencing hydroquinone  (or another melanin suppressor) protects the skin from rebound hyperpigmentation that can occur with a laser. See below for an explanation of hydroquinone action.
  2. Alternative treatments to hydroquinone. Some people are sensitive or cannot or do not want to use hydroquinone. These include vitamin A, Vitamin B (niacinamide), Vitamin C (ascorbic acid) kojic acid, arbutin, azelaic acid. Combinations of these are often used in treatment such as DERMALAN which act as the bleach part of the therapy.

Melasma Facts.

  • More common in women with darker skin types
  • High-risk populations have an incidence of 9 – 50%
  • In the general population, the risk is 1%
  • Causes of melasma sun  exposure
  • Hormonal influence & genetics major cause
  • Hyperpigmentation most commonly in centre face, map-like patches. 
  • Occurs on the forehead, cheeks most commonly.
  • Can occur on neck, décolletage and even on lower arms and legs.

What is Melasma?

It is caused by hyper-functional pigment-producing cells (melanocytes) This causes excessive deposits of melanin (brown pigmentation)  in the epidermis (superficial) or and or dermis (deep) melasma.  In some cases, there is also increased blood vessels and signs of sun damage or inflammation.

Melasma Causes

A combination of oestrogen and sun exposure causes melasma. There is a genetic predisposition, and though it can occur in men, this is rare. Melasma commonly appears at times of use of the oral contraceptive pill or during pregnancy (called chloasma ) when the oestrogen hormone levels rise.

The hows and whys of melasma treatment.

To understand how and why melasma treatment it is essential to have an understanding of the pathway in your skin to form melanin.  The basics of treatment are.

  1. Treatment to decrease pigmentation in the skin –  peels, laser, vitamin A
  2. Treatment to decrease new pigmentation produced by melanocytes with topical treatments.  Vitamin A,

Bleach-Peeling Melasma Treatment

Understanding the different actions of melasma cream, it makes sense to combine them for a more effective treatment of melasma. The classic combination that works in 90% of superficial is a combination of Bleaching cream such as Kligman’s formula, which contained hydroquinone & retinoic acid and peeling consisting of a series of chemical peels.

As our knowledge of melasma cream has increased, quite often the traditional bleaching formula has added azelaic acid, vitamin c or niacinamide. Also with the use of hydroquinone being prohibited or concerns with its use has to lead to HQ free options. With combinations of several of the topical treatments.

In our opinion, the fastest route as long as you do not have a sensitivity to hydroquinone remains the gold standard for bleach peeling.

Good Sun Protection is Essential in Melasma & Chloasma Treatment

With melasma and chloasma, the last and most important piece of the puzzle is SPF protection 365 days per year to prevent further production of skin pigment. So all through the combination of melasma cream and peels or laser will settle the hyperpigmentation, it will recur immediately with sun exposure or other skin irritation.

  • The oestrogen changes the way skin pigment responds to sun exposure.
  • Adequate sun protection is essential to prevent recurrence
  • in Brisbane our summer sun is relentless and even with vigilant Spf protection additional melasma cream used over the hottest summer months may be required.

Summary Melasma Cream vs Laser for Melasma

Melasma cream and peels for melasma are the best approaches at the outset. Laser treatment of melasma is reserved for resistant cases only because of the risk of side effects.
No referral is required to our clinic, and you will be booked in for a free assessment with our Cosmetic Nurse or therapist.

Call Us Today On 3350 5447 For A FREE Consultation With Our Dermal Therapists or Email Us With Any Queries

 

 

 

Melasma Treatment Summary

Step 1. Avoid Melasma Causes

  • Sunscreen and sun protection.
  • Discuss changing OCP with your General Practitioner. It is not always possible to change, but this gives melasma the best chance to settle.

Step 2 – Melasma Cream To Prevent New Pigmentation.

The essential ingredients include Vitamin A PLUS Hydroquinone 4%.
Even with prescription creams, it still takes up to 4 weeks to notice fading.

Step 3 – Melasma Removal – Best Peel For Melasma

Clearing pigmentation from the skin with superficial peels or Fractional Laser. The best peel for melasma is a superficial peel. These can include vitamin A peels or AHA peels such as lactic acid.

  • Chemical peel for melasma work by shedding of the excess pigment.
  • 10- 20% Lactic acid peels or Vitamin A peels.
  • Chemical Peels are performed every 2 to 4 weeks and are well tolerated.
  • There is no downtime with this peeling.

Fractionated treatments can give excellent results in resistant cases of melasma. Usually, 2-6 treatments are needed. Laser treatment is NEVER the first line treatment of melasma and only used for cases where other treatments have failed. There can be complications of worsening of pigmentation in some cases.

Step 4 – Prevent Melasma

The last step of melasma treatment is to prevent the melasma returning.

    • Ongoing sun protection is essential
    • 2% hydroquinone or niacinamide over the hot summer months.
    • Melasma is never cured so you may need to consider intermittent treatment.

Call Us Today On 3350 5447 For A FREE Consultation With Our Dermal Therapists or Email Us With Any Queries

If you do require a prescription, you will be referred to our Doctors. There is a consultation fee with this.

Call on 3350 5447 to Book a FREE Assessment  
* DISCLAIMER: Results may vary from person to person.