For some, it may begin with the appearance of small brown spots, and then it spreads and worsens becoming a bigger patch. While most may see Melasma as a superficial problem, it can have detrimental effects on an individual’s self-esteem as it worsens.
Melasma often appears on the cheeks, forehead, nose, upper lips and chin.
How are Pigmentation formed?
Pigmentation is brown spots or patches on the skin caused by an excess production of melanin in the skin. Melanin is produced by cells called melanocytes at the lower layer of the epidermis and can be triggered to produce melanin by sun exposure. Other common factors that can trigger pigmentation include hormonal changes, pregnancy, genetics and skin trauma/inflammation caused by acne.
What is Melasma?
Melasma is a common skin problem which is the appearance of pigmented patches on the skin.
Also referred to as chloasma, or the “mask of pregnancy”, this condition is much more common in women than in men, though men can get it too. According to the American Academy of Dermatology, 90% of people who develop melasma are women.
The diagram below illustrates the human skin layer and the Melanocytes are the melanin-producing neural crest-derived cells located in the bottom layer (the stratum basale) of the skin’s epidermis.
Symptoms of melasma
Melasma is manifested as patches of discolouration and is darker than usual skin colour. Common areas affected are usually on the face and it may be symmetrical on both sides of the face. Other areas of the body which are often exposed to the sun, can also develop melasma.
Melasma typically appears on the:
- bridge of the nose
It can also develop on the neck and forearms. Untreated Melasma can become more severe and progress to become bigger patches.
Types of Melasma?
There are 3 types of Melasma: epidermal, dermal and mixed
- The epidermal type is identified by the presence of excess melanin only in the superficial layers of the skin.
- Dermal melasma is distinguished by the presence of melanophages (cells that ingest melanin) throughout the dermis.
- The mixed type includes both the epidermal and dermal type.
Causes and risk factors of melasma
There is no clear evidence on what exactly causes melasma but there is a strong genetic predisposition in those affected by Melasma.
Other causes/ triggers include:
- Estrogen and progesterone sensitivity are also associated with Melasma
- Hormonal treatment: Birth control pills that contain Estrogen and Progesterone, Hormone treatments
- Exposure to UV rays / Sun
- Thyroid disease: Hypothyroidism
Here are some tips to prevent Melasma from becoming more severe.
1. Use sunscreen. It’s important to apply sunscreen (min SPF 30) everyday.
2. Avoid sun/UV exposure. Try to avoid direct strong sun exposure, especially in the middle of the day. Also, avoid saunas and steam rooms, as excessive heat can also worsen melasma.
3. Topical lightening products. Products containing ingredients such as kojic acid and glycolic acid may be used during pregnancy—but best to check with your doctor. It helps minimize the intensity and severity of Melasma by inhibiting pigment production.
4. Avoid traditional skin-bleaching and lightening creams. Products containing hydroquinone, retinoids, and steroids are a big no-no during pregnancy.
How to treat Melasma?
Thankfully, we have the full range of Melasma treatment options available in our Singapore Clinic.
At M-Aesthetic Clinic, Dr Ho Rui Ming with years of experience has an effective Melasma treatment programme. He believes that a combination of different treatments that target the different pathways of pigmentation production can help to effectively treat/ reduce Melasma.
1. Proprietary whitening creams
The Ultra Whitening Complex is an intense proprietary-only whitening cream that combines multiple, effective proven whitening ingredients to treat pigmentation.
2. Oral tablets
Certain oral medications target pathways in pigmentation formation and helps to lighten different pigmentation conditions.
A well-known supplement that is proven to help to reduce pigmentation is Heliocare Max 240 Purewhite Radiance.
Containing an additional dose of Fernblock®, it has an excellent antioxidant property that is able to reduce free radicals by up to 50%, preventing the formation of hyperpigmentation caused by UV rays.
A recent study conducted in National Skin Centre, Singapore, showed a 62% improvement in melasma when compared to baseline in just 12 weeks.
Furthermore, Purewhite Radiance Max 240 is enhanced with the exclusive blend of White Tech Complex where it controls and blocks the main enzyme that is responsible for melanin production. The blend in White Tech Complex consists of Pomegranate extract, L-Cystine, vitamin C and B3, all clinically proven to promote skin fairness and radiance
Combination of different lasers for melasma and pigmentation
Developments and advancement in technology have introduced more options for non-surgical procedures especially in Laser Treatments. Apart from being very effective, these laser procedures often require no to almost minimal downtime and are quick and pain-free.
Pigmentation Lightening Laser
The popular laser treatment, which has no downtime, is also known as the “Hollywood Peel”. This is a photo-enhancer based laser treatment.
The procedure is safe on all skin types and is a fantastic way to brighten up your skin without the longer downtimes associated with other procedures!
It uses no harsh formulas or abrasive scrubbing tools, which means no bleeding and adverse chemical reactions; yet promises the instant effects one would expect from a professional face peel.
It takes about 30 minutes. The carbon lotion is applied to the skin first and the laser heats the carbon lotion to penetrate into the pores for a deep exfoliation. Then, the laser removes the carbon. With it comes dead skin cells and anything that was clogging the pores, leaving your skin clear, bright and toned.
What kind of improvement can I expect to see with this treatment?
- Improves melasma and other signs of sun damage
- Treats pigmentation
- Improves skin tone, texture and elasticity
- Brightens and tightens skin for a natural, well-rested look
- Reduces all types of acne
- Controls sebum production
- Reduces redness from inflamed acne
For best results, subsequent sessions are needed.
Thulium BB Laser
The Thulium BB Laser is a stronger laser treatment that effectively targets facial pigmentation, Melasma, brightens the skin and improves size of pores. In South Korea, many call it the BB Laser because of its ability to improve the texture and tone of the skin, just like when applying BB cream to the skin.
Thulium BB Laser is a unique sub-ablative thulium 1927nm laser for skin resurfacing and rejuvenating. The laser’s wavelength penetrates to a level between the lower part of the epidermis and dermis where it is able to target freckles, sunspots, age spots and Melasma while renewing damaged skin and stimulating collagen production.
The wavelength penetrates the upper dermis while not causing the upper layer to peel.
What kind of improvement can I expect to see with this treatment?
- Improvement in pigmentation & Melasma
- Skin brightening/ Fairer skin
- Smoother, younger looking skin
- Pore tightening
- Overall improvement in skin texture and tone
- Improvement in fine wrinkles
Thulium BB Laser can be combined with Pigmentation Lightening Laser to successfully reduce appearance of Melasma.
How long must one go through this treatment plan?
Depending on the severity of the pigmentation, the number of sessions may vary from 5 sessions of laser treatment depending on the extent and severity of the pigment condition, with a gap of 2-3 weeks in between these laser pigmentation treatment sessions.
During the consultation, Dr Ho will meticulously examine and assess your skin condition to determine the best treatment plan
It is common to have Melasma, but it is a struggling problem faced by many as they do not take quick action to treat it. It is best to treat Melasma quickly so that it can yield quicker results and get it under control as soon as possible before it reaches more severe/ stubborn stages.
If you are facing these symptoms of Melasma, make an appointment now with Dr Ho Rui Ming so that he can come up with the most suitable and effective plan for you.