Melasma

[Sito2001]

HI! I am 43 y/o with a dx of Melasma since my last pregnancy on 1994. Since then, I'll be living with the horrendous dark marks in my face with no treatment at all.  I had a Partial Hysterectomy surgery on 2005 that aggravated my condition. There is a lot of treatment in the market like creams, laser, peelings and others that promising extraordinary results. I would like to ask: Which one of those treatment do you recommend at short term and less expensive?

Thanks.

[BhumikaMD]

Hi,

The treatment options available are -
'Topical depigmenting agents, such as hydroquinone (HQ) either in over-the-counter (2%) or prescription (4%) strength. HQ is a chemical that inhibits tyrosinase, an enzyme involved in the production of melanin.

Tretinoin, an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy.

Azelaic acid (20%), thought to decrease the activity of melanocytes.

Facial peel with alpha hydroxyacids or chemical peels with glycolic acid.'

'Laser treatment for melasma - A Wood's lamp test should be used to determine whether the melasma is epidermal or dermal. If the melasma is dermal, laser (or "IPL") will acually DARKEN and worsen the appearance of the spots. Dermal melasma is generally unresponsive to most treaments, and has only been found to lighten with products containing mandelic acid.

In all treatments for melasma the effects are gradual and a strict avoidance of sunlight is required. The use of broad-spectrum sunscreens with physical blockers, such as titanium dioxide and zinc dioxide is preferred over that with only chemical blockers. This is because UV-A, UV-B and visible lights are all capable of stimulating pigment production.'

You should consult your doctor about this and whether laser treatment would help in your case.

You could read more about this at the following links -

http://en.wikipedia.org/wiki/Melasma

and

http://www.emedicine.com/DERM/topic260.htm

Let us know if you need any further information.

Regards.