Don’t hide behind the mask. Melasma do’s and don’ts.

It’s known as the “mask of pregnancy”,  but it very well could be called the “mask of contraception” or the “mask of hormonal outrage”.  Melasma is dark pigmented patches of skin that plague the faces of a good quarter or more of my clients.  It’s a rare day that passes when I don’t have a gal in my chair lamenting her lost even skin tone. Melasma is one of the medical community’s annoying oddities that no one can quite figure out.   This small detail makes it a bit of a challenge to wipe off the face of the planet…..or at least off of your face. We do know that it is hormone related and that sun exposure makes it much worse.  Dark pigment in the skin is produced by overactive melanocytes (small cells that create pigment in our skin).   One of the first things my clients want to do is laser their faces off in hopes of destroying the malicious pigment.  Lasers may not always be the best option.  The trick to lifting the mask is removing the top layers of pigmented skin (microdermabrasion, retinoids, and/ or chemical peels) and suppressing the melanocyte that is producing the brown spots with tyrosinase inhibitors (hydroquinone, kojic acid).  Here are my top do’s and don’ts when fighting melasma:

  1. Don’t spend hundreds of dollars on skin care and treatments and then slather on sub par sunscreen, or worse forget it entirely.
  2. Do think of sunscreen as your first line of defense.  Sunscreen keeps the skin from sustaining as much “injury” from the sun.  (Melasma is made worse by stimulation of melanocytes, which are the cells that produce pigment!) follow me?  Apply your sunscreen every 2 hours when out in the sun.  I’m obsessed with Colorscience’s powdered sunscreen.
  3. Don’t hang out in the sauna or hot tub.  Studies show that heat can cause the melanocytes to rear their ugly heads and start to pump out extra pigment.
  4. Do get religious about your skin care routine.  Consistency is key when applying skin lightening products so don’t go to bed without dousing yourself in the creams your skin care professional recommends.
  5. Do add in the gold standards for treating pigment: tretinoin + hydroquinone + vitamin c.  You can alternatively look for non prescription products that have retinols, kojic acid, alpha hydroxy acids.  It’s going to take 3-6 months to see a big change either way.
  6. Don’t jump right in to photofacials or IPL.  Studies show that melasma can be made worse following these treatments.  In my personal practice, photofacials tend to offer minimal benefits and carry too much risk for melasma.
  7. Do  try the safer medium depth chemical peels that are on the market today.  My personal favorite is the VI Peel.  It will make you peel like a snake and even out your skin by lifting off surface pigment.  You’ll still need your skin care products but peeling makes the process move along much faster.

    before/after Vi Peel

 

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