Melasma is a chronic skin disease that causes spots on the face; brown, beige, or even bluish-gray patches usually appear on the top of the cheeks, above the lips, forehead and chin. The main factors responsible for this disorder are hormonal changes and sun exposure; therefore, the most effective way to cure it in the long run is to reduce or eliminate its causes. Many women suffer from melasma during pregnancy, and in these cases, the blemish should typically fade naturally after the baby is born.
Steps
Method 1 of 3: With Prescription Drugs
Step 1. Visit your family doctor
Before seeing your dermatologist, talk to your doctor about changes in hormone medications and creams you can try to manage melasma. Treatments for this disorder can be considered elective and are not always covered by the National Health Service (or even by any private health insurance, if you have one). Find out about any coverage and / or costs before planning any type of treatment and procedure.
Step 2. Stop any drug therapy that may be responsible for the problem
Some medicines, such as birth control pills and hormone replacement therapy, can affect hormones and induce melasma; talk to your doctor about stopping these medications.
Although pregnancy is generally the most common circumstance associated with the disease, the disorder is actually known to develop due to drugs or other disorders that affect the endocrine system. Oral contraceptives and HRT are the first two factors responsible for the problem after pregnancy. You can stop taking them or try swapping them for other medications and see if the melasma naturally reduces
Step 3. Change your hormone treatment
It is often impossible to stop hormone replacement therapy; you have to evaluate your reason for taking this treatment to determine whether or not you can stop it or at least change the dosage. However, there are techniques for changing therapy so that there is less chance of this disorder developing; check with your gynecologist before making any changes.
- Start by taking your hormones in the evening. If you take them in the morning, they may reach their peak of effectiveness when the sun comes up, thus increasing the risk of melasma; by shifting the time of hormone therapy to the evening, you can alleviate the problem.
- You can try using creams or patches which usually tend to cause less skin discomfort than systemic treatment.
- Ask your doctor to give you the lowest possible dosage.
Step 4. Ask the doctor to prescribe hydroquinone cream
However, please note that this product is banned for cosmetic use in Europe due to certain side effects, but can be used as a lightener when medical need exists. Some low-strength creams can be sold without a prescription, but your dermatologist or family doctor may prescribe one in higher dosages, which is more effective against melasma.
- Hydroquinone is available in the form of a cream, lotion, gel or even liquid; it works by blocking the skin chemical process responsible for the production of melanin. Since the latter is responsible for the dark pigmentation of the skin, the concentration of pigments related to melasma is consequently reduced.
- Prescription hydroquinone typically has a 4% concentration; It is very difficult to prescribe a cream with a higher concentration, because it can be dangerous and lead to ochronosis, a permanent form of abnormal skin pigmentation.
Step 5. Talk to your doctor about a secondary lightener
Although hydroquinone is used as a first choice treatment in many cases, the dermatologist may choose to prescribe another treatment to intensify its effect.
- Tretinoin and corticosteroids are among the most frequently used secondary treatments; both accelerate the cell turnover of the epidermis. Some dermatologists may also prescribe a "triple action" cream that contains tretinoin, a corticosteroid, and hydroquinone in a single formula.
- Other solutions involve the use of azelaic or kojic acid, which slow down the production of dark skin pigments.
Method 2 of 3: With Professional Procedures
Step 1. Get a chemical peel
This treatment uses glycolic acid or other similar chemical abrasives to eliminate the superficial skin layer affected by melasma.
- A liquid is applied to the skin, creating a slight chemical burn; as the burnt layer flakes off, fresh, blemish-free new skin appears. However, keep in mind that if you haven't addressed the hormonal imbalance responsible for melasma, that solution won't cure it.
- Although glycolic acid is one of the most used substances for this purpose, a valid alternative is trichloroacetic acid, which is quite similar to vinegar. There is usually a slightly more painful sensation at the end of the peel that is performed with this chemical, but this treatment is a great option in severe cases.
Step 2. Evaluate microdermabrasion and dermabrasion
In these treatments, the upper layer of skin is gradually removed, leaving in its place a new, clean epidermis free from imperfections.
- In both cases, these are medical procedures that essentially "sand" the surface layer of the skin with an abrasive material. During microdermabrasion, very fine abrasive crystals are applied to the skin and are powerful enough to forcefully remove dead cells, "sweeping" away the affected skin layer.
- There are usually five sessions, 2-4 weeks apart. If the underlying cause of melasma is not addressed, you can also choose to have maintenance treatment every 4 to 8 weeks.
Step 3. Proceed with caution with laser treatment
Although in some cases the procedure can remove the skin layer affected by melasma, it can aggravate the situation by worsening the appearance of the skin. Only undergo this remedy if you know for sure that it is performed by competent and accredited professionals. Look for reconstructive or dual fractional laser treatments that target pigmented areas only.
Fractional laser therapy tends to be more expensive and can cost up to 1000 euros or more; keep in mind that 3-4 sessions may be needed over a 3-6 month period
Step 4. Try Platelet Rich Plasma Treatment
In this case, the plasma is enriched to stimulate healing and is injected into the body. It is an experimental procedure and not yet fully understood; however, the first results show that it is not only able to treat melasma, but also to prevent its recurrence.
Method 3 of 3: With Non-Prescription Home Treatments
Step 1. Protect your skin from the sun
Apply a broad spectrum sunscreen and take other measures to protect the skin from the sun's rays; This way, you can avoid melasma outbreaks and reduce the risk that the one present will get worse.
- Apply the cream 20 minutes before going out in the sun; look for one with a minimum SPF of 30 and check that it is enriched with nutrients, such as zinc, which are beneficial for the skin.
- You can also "double up" your sun protection by putting one layer of cream with SPF 15 and another with SPF 30.
- Wear a wide-brimmed hat and large sunglasses to give your face extra shelter. If melasma is particularly stubborn, you should also consider wearing long-sleeved clothing and long pants. avoid as much as possible to expose yourself to direct sunlight.
Step 2. Relax
Stress can aggravate hormonal imbalance, and if this is the cause of your problem, you need to find remedies to reduce it so you can better manage your melasma.
If you have a hard time relaxing, try different techniques, such as meditation or yoga. If you don't get results or feel uncomfortable, just take some time to do more things you enjoy; it could be walking in the park, reading a book or taking a bubble bath
Step 3. Get an over-the-counter cream with hydroquinone
This medical ointment lightens the skin by reducing the appearance of breakouts.
- It is a product available in the form of cream, lotion, gel or liquid and works by blocking the natural chemical process responsible for the production of melanin; since it is precisely the latter that produces the dark pigmentation of the skin, with hydroquinone the quantity is reduced.
- There are also hydroquinone creams that provide a light sunscreen; therefore, if you want to protect your skin while treating melasma, this option offers a double benefit.
- Hydroquinone creams available for free sale generally have a maximum concentration of 2%.
Step 4. Try a cysteamine ointment
This substance is naturally present in the cells of the body, it is safe and proven in the treatment of melasma.
It is a natural product of L-cysteine metabolism; it acts as an intrinsic antioxidant and is known for its protective action against ionizing radiation and as an antimutagen agent. Its job is to inhibit melanin synthesis to trigger depigmentation
Step 5. Use kojic acid or Melaplex cream
Both of these substances are able to lighten the skin, but are a little less aggressive and irritating than hydroquinone; they slow down the production of the pigment, consequently leading to a new production of less dark skin cells that prevent melasma from taking root.
Step 6. Take tretinoin
It is a type of vitamin A that increases the speed of skin cell turnover, thus favoring a rapid reduction in the intensity of melasma spots.
However, keep in mind that this product alone cannot cure the disease unless you have resolved the underlying cause first; the affected skin may flake more quickly, but it has no effect if new cells are also affected by the disorder
Step 7. Try paper mulberry
It is a plant that grows as a small shrub or bush, and although it has many non-medical uses, its products and extracts can be used as oral or topical remedies to treat melasma as long as the instructions on the package are followed.
Step 8. Try other holistic treatments
Other topical substances that have been shown to be useful include cranberry, watercress, mandelic acid, lactic acid, lemon peel extract, apple cider vinegar, and vitamin C. All of these products are capable of reducing compounds in the production of skin pigment, but without completely canceling them and without causing irritation or sensitivity to light.
Step 9. Wait
If the melasma has been induced by pregnancy, it will subside after delivery; however, it is likely to recur in the event of future pregnancies.
