Melasma & Post Inflammatory Hyperpigmentation

Melasma, is a skin condition in which progressive brown pigmented

patchesappear on the face, mainly on the cheeks, forehead and upper lip.

This condition primarily affects women and is triggered by several factors,

including genetic and hormonal factors. It is sometimes called the 'pregnancy mask'.

 Melasma is induced by UV exposure and in some patients even by skin exposure to daylight.

It is a chronic recurrent condition that flares up regularly, so a long-term strategy is to be considered

when discussing treatment options.

Post Inflammatory Pigmentation or PIH is the residual brown pigmentations that is formed in the healing phase after skin inflammation or during wound healing, like after acne, traumatic wounds or burns. Dark photo types are

more prone to PIH. PIH can disappear spontaneously but usually takes several months or years.

The treatment of melasma and PIH initially consists of daily sun protection with high SPF,

preferably tinted or with large spectrum (including blue light protection).

This is essential as without adequate UV protection, all treatments will fail.

The next step is to use a very potent topical depigmenting cream based on hydroquinone (HQ):  triple cream

or Kligman formula with hydroquinone, tretinoine and hydrocortisone. This potent cream can only be used

for 2-3 months and needs to be alternated with non-HQ topical depigmenting agents like azelaic acid, 

kojic acid, niacinamide, tranexamic acid and vitamin c.

Alternative or maintenance treatment options we offer are:  chemical peels and certain laser treatments. Not all laser treatments are suited to treat melasma. We use two different FDA approved lasers (1) the Spectra laser toning and carbon laser peel and (2) LaseMD: thulium laser assisted cosmeceutical delivery of tranexamic acid (potent topical depigmenting agent) or vitamin C (topical for skin brightening and anti-ageing).

Possible treatments

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