How To Treat Melasma

melasma_girlI discussed melasma in a previous blog post entitled, “Melasma: The Tan That Doesn’t Want To Go Away“.  However, I published that post over 3 years ago, so I don’t blame you if you haven’t read it or even remember it.  A new study published recently involving melasma and its treatment influenced me to bring the subject back again.

For those of you who didn’t read that last blog post or simply don’t know, melasma is an acquired, not hereditary, skin condition that results in light and dark brown irregular patches appearing on the face and neck.  No one has yet discovered the root cause of melasma and this condition can vary greatly in intensity from person to person.

There are known factors that can start and worsen the condition.  These factors include exposure to sunlight and heat, aging, and especially hormone fluctuations.

Melasma is predominantly seen in women with a high association around the time of pregnancy.  In most patients, the brown patches can wax and wane depending on sun exposure and hormonal state at the time.

The severity of melasma depends on how deep below the skin surface the pigmentation changes occur.  The deeper the pigment in terms of skin layers, the more treatment is a challenge.  In most patients, melasma is never cured, but can be treated and frequently controlled.

melasma_graphicA recent study from the Scripps Clinic in San Diego published in the medical journal Lasers in Surgery and Medicine looked at the treatments for melasma and specifically the effectiveness and safety of lasers.  In this study, current therapies were reviewed including topical bleaching creams, sun avoidance, chemical peels, dermabrasion, and the use of lasers.

After much analysis of previous studies and the results of this study, the conclusion was that a combination approach to melasma worked best, and that lasers can be combined with topical therapies safely without clinically significant side effects.  The specific combination of a form of dermabrasion, topical bleaching agents, and laser did show significant melasma clearance, but the duration of clearance was clearly related to the degree of sun avoidance (which is obviously difficult in southern California where the study was conducted for the most part).

Here at Maine Laser Skin Care, I have definitely found melasma to be a challenging condition to treat, but the results are extremely gratifying when I have succeeded in its treatment.  Women who previously had to wear heavy makeup and/or avoided social situations because of this condition feel liberated.

Our current, most successful combination includes Hydrafacials, Obagi NuDerm System and use of laser depending on the severity of the melasma.  Many patients can respond to one of the above while others require all three.

melasma_laserI always must emphasize that the treatment of melasma is a long-term process, requiring ongoing responsibility for sun avoidance and retreatment for recurrence or resumed darkening.  As always, the initial consultation is the key to determining which combination will be best for you while reassessment and adjustments in therapy may be needed depending on your response to initial treatment.

If you or someone you know has melasma, don’t despair.  There is hope and treatment.  We have treated many people who thought that they were “hopeless cases” and we have dried many tears and changed them to smiles.

Call Denise or Becky at (207) 873-2158 to set up a free initial consultation to assess melasma or any other aesthetic concern.

About Dr. John Burke

John Burke M.D. has practiced medicine for over 25 years, and is the founding partner of MidMaine Internal Medicine. He established Maine Laser Skin Care in 2004 after devoting years to learning the latest in laser and dermatologic technology. Dr. Burke has treated patients from all over the United States. He is one of Maine's busiest practitioners in laser treatments, and in the use of Botox for upper facial lines and excessive sweating.
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