Melasma Treatment
Melasma, also called ‘chloasma’ and ‘pregnancy mask’, is a chronic skin condition in adults in which brown or greyish patches of pigmentation (colour) develop, usually on the face.
Melasma, also called ‘chloasma’ and ‘pregnancy mask’, is a chronic skin condition in adults in which brown or greyish patches of pigmentation (colour) develop, usually on the face. It is more common in women, particularly during pregnancy (when up to 50% of women may be affected). Sometimes men may also be affected. Melasma is more common in people of colour and those who tan very quickly but can happen to anyone. It is also more common in people with a family history of the condition, but it is not hereditary.
Melasma appears darker than the surrounding skin- affecting the cheeks, forehead, upper lip, nose and chin. It can also affect other areas of the body exposed to the sun, such as the forearms and neck. Areas of melasma are flat, not raised.
It usually becomes more noticeable in the summer and improves during the winter months.It is not an infection; therefore, it is not contagious, and it is not due to an allergy. It is not cancerous and will not develop into skin cancer. Melasma is usually easily recognised by doctors from its appearance.
Exposure to ultraviolet (UV) light from the sun and the use of sun-beds or phototherapy can trigger melasma or make it worse.
The exact cause is not known, but it is thought to be because of pigment-producing cells in the skin (melanocytes) producing too much pigment (melanin). Several factors can contribute to developing melasma, including pregnancy and using hormonal drugs such as birth control pills and hormone replacement. Rarely, other medical problems that affect hormones (such as thyroid problems) may cause melasma, as well as some other medications, such as antiepileptics.
Most patients are upset by the appearance of melasma, but it has no physical symptoms. Affected skin is not itchy or painful.
At present there is no cure for melasma, but there are several treatment options that may improve the appearance. If melasma occurs during pregnancy, it may go away a few months after delivery and treatment may not be necessary- though it may come back during another pregnancy. Hydroquinone and retinoid creams should be avoided in pregnancy as they could harm the foetus. Even if it is treated, melasma often returns after stopping the treatments.
Melasma treatments fall into the following categories and can be used together:
Avoiding known triggers, such as birth control pills and hormone therapy.
Using sun-blocking creams, and avoiding direct exposure to the sun.
Skin lightening creams.
Procedures such as chemical peels, microneedling and laser therapy.
Skin camouflage.
PicoSure is the first picosecond laser technology, which delivers ultra short bursts of energy measured in one trillionths of a second to shatter the pigment into small particles that are absorbed and discarded by our immune system.
The PicoSure Laser is a unique treatment option for melasma because it does not produce heat so it doesn’t “burn” the pigment, it shatters it. Without heat, there is no risk of causing inflammation in the skin and therefore much less risk for triggering melasma.
A secondary benefit of the PicoSure Laser’s unique picosecond pulse is “cell-signaling” that produces significant rejuvenation of the treatment area resulting in tighter, brighter skin with an improvement in texture and tone. All that with absolutely NO downtime. PicoSure Laser is also a great treatment for a person with darker skin types.
The procedure is fast, straightforward and only causes a bit of minor discomfort. The sensation of these lasers removing the unwanted pigmentation feels almost like a rubber band lightly snapping on your skin. Each session lasts a mere ten minutes, meaning that the treatment is easy to work into your busy lifestyle.
PicoSure lasers for melasma removal can help remove unwanted pigmentation on your hands, face, or anywhere on your body.
Can PicoSure make melasma worse?
The risk with all types of laser treatments is causing further damage and making melasma worse. With extended heat-based lasers, there is a chance of exacerbating skin issues, so while treatment may remove melasma, it can also lead to other unsightly blemishes in the future. In some cases, extreme heat can even cause melasma to recur, which is the exact opposite desired effect.
PicoSure, however, is a little different. The technology used in the PicoSure laser is designed to combat the damaging processes seen with other types of lasers. With rapid-fire lasers come less time for heat damage within the skin. This can reduce the risk of painful or unpleasant side effects, like redness and prolonged downtime.
That said, you must be aware even though PicoSure laser is specially designed to reduce the risk of melasma returning or worsening after use, there is still a very small chance that melasma may flare following treatment.
The PicoSure laser using the Focus lens array produces an intense burst of light. All personnel in the treatment room, including myself, will wear protective eyewear to prevent eye damage from this intense light.
Prior to the treatment, test spots may be performed. Test spots help to determine effective treatment settings, and can require you waiting 2 weeks prior to starting treatment, so we can evaluate your response.
The sensation of the laser on the skin may feel like a slight pin prick or the sensation of heat. The sensation of heat may last for an hour or longer after the treatment. Cold air or a cool gel pack may be used during the treatment or post treatment to cool the skin and to minimize warmth. You will also hear a slight snapping sound during the treatment and feel the touch of the laser distance gauge (part of the device) in the treated area.
Following the procedure, you may have redness or slight swelling in the treated area; this may last for 24 hours. You may also develop an acne-like breakout or slight darkening of the pigment; it should resolve without intervention in 3 - 7 days.
The area should be treated delicately following treatment. Multiple treatments may be necessary.
With Vivier’s Hyperpigmentation Program (2% Hydroquinone) and just 4 minutes a day, you can erase years of skin damage. Vivier’s pharmaceutical grade skin restoration program will gently and effectively restore your skin’s vitality so you can enjoy visible improvements in dark spots, aging skin, irregular skin texture and tone.
For mild, moderate to severe skin conditions.
Your customized Hyperpigmentation Program (2% Hydroquinone) includes six full size pharmaceutical grade products in an elegant cosmetic bag:
- Medicated Wash
- Advanced Skin Lightening Serum
- Corrector 2
- Exfoliant Forte
- Retinol 1% Night Complex
- Sheer Broad Spectrum SPF 45
With Vivier’s Hyperpigmentation Program (Non-Hydroquinone) and just 4 minutes a day, you can erase years of skin damage. Vivier’s pharmaceutical grade skin restoration program will gently and effectively restore your skin’s vitality so you can enjoy visible improvements in dark spots, aging skin, irregular skin texture and tone.
For mild skin conditions.
Your customized Hyperpigmentation Program (Non-HQ) includes six full size pharmaceutical grade products in an elegant cosmetic bag:
- Medicated Wash
- Radiance Serum
- Skin Brightening Cream
- Exfoliant Forte
- Retinol 1% Night Complex
- Sheer Broad Spectrum SPF 45
Jessner Peel
The Jessner Peel is a highly concentrated chemical peel with 3 active ingredients, combining their respective properties to provide optimal treatment.
First, lactic acid deeply exfoliates the skin and evens out the superficial layers of the epidermis.
Then, salicylic acid regulates the effect of sebum, in addition to acting as an anti-inflammatory and antimicrobial agent.
Finally, resorcinol acts as a catalyst by enhancing the benefits of the first two acids.
Together, these three substances penetrate deep into the dermis to provide it with all the sought-after benefits. It will give your complexion a perfectly radiant, healthy and tonic look.
The Jessner peel is done by brushing an acidic liquid onto the skin to remove the top layers and encourage new, younger looking skin to grow.
The Jessner peel has the ability to:
- treat melasma (skin discoloration), hyperpigmentation, and acne scars
- reduce dark patches and age spots
- even out skin tone
- reduce the appearance of scars
- smooth fine lines and wrinkles
We recommend a minimum of 3 to 6 treatments, each spaced 4 weeks apart, to see a significant improvement.
This treatment can be repeated when appropriate, depending on the patient’s skin condition
Pre-treatment/Post treatment Instructions - PicoSure®
Precautions to take before your light-based treatment:
- No sun exposure, tanning beds and sunless tanning cream for 4 weeks prior to treatment. Sun exposure decreases the effectiveness of the laser treatment and can increase the chance of Post treatment complications.
- Use a broad spectrum UVA/UVB sunscreen with an SPF of 30 or higher. Apply to the treated area every 2 hours when exposed to the sun and it is recommended to make this a part of your skin care routine.
- Remove all makeup, creams or oils prior to treatment.
- Be sure to inform your care provider if you have ever had cosmetic tattoos or cosmetic pigmentation or permanent makeup applied near the area of treatment.
Instructions following your laser treatment:
General (Pigment and tattoo)
- Cleanse the treated area at least daily with water and mild soap, and then pat the area dry.
- Do not rub or scratch the treated area.
- If crusting/scabbing occurs, do not shave or pick the area. Apply Aquaphor ointment (tattoo) or other moisturizer (face) to the area 2 - 3 times per day. Keep the area moist, and let the crusting/scabbing resolve on its own.
- If you are prone to breakouts or have oily skin, consider waiting 24 hours before applying any topical products.
- Discomfort may be relieved by cold gel packs and/or an over the counter pain reliever, such as acetaminophen.
- Avoid contact sports or any other activity that could cause injury to the treated area.
- Avoid swimming, soaking or using the hot tub/whirlpool until the skin heals.
- Contact your physician if there is any indication of infection (redness/tenderness or pus).
Vivier® and Jessner peels
Pre-treatment instructions
(Three days before the treatment)
Avoid the following procedures: electrolysis, waxing, depilatory creams and laser hair removal
Stop using exfoliating products that may be drying or irritating
Stop using products containing Salicylic Acid, Alpha Hydroxy Acids, Retinol, prescription Retinoids or Benzoyl Peroxide such as the following Vivier products:
- Medicated Wash
- AHA/BHA Exfoliating Cream
- Exfolliant Forte
- 0.3% Retinol SR Complex
- Retinol 1.0% Night Complex
- Peptide CR Creme
- Peptide CR Eye Creme
- Acne Treatment Lotion
What to Expect During and After the Treatment
You may experience a slight tingling sensation as the treatment activates on your skin
Approximately 48 hours after the treatment, your skin may peel, be red, dry and irritated
Skin may take on a sunburn appearance
Peeling and redness, if any, may last for 3 to 5 days
The amount of sloughing experienced will vary depending on the condition of your skin and the home care products you use
The amount of peeling observed is not an indication of the effectiveness of the treatment
Post-treatment
The night of your treatment rinse your skin gently with water only and pat dry
Do not rub or pull your skin as scarring may result
Avoid vigorous activities, swimming and hot showers, especially in the first 24 hours following the treatment
Avoid harsh cleansers, washcloths, scrubs or loofahs for 48 hours following your treatment (gentle scrubs such as the Vivier Vitamin C scrub are safe to use)
Do not use products containing Salicylic Acid, Alpha Hydroxy Acids, Retinol, prescription Retinoids ro Benzoyl Peroxide up to 48 hours following your treatment or once peeling, redness or dryness subsides such as the following Vivier products:
- Medicated Wash
- AHA/BHA Exfoliating Cream
- Exfolliant Forte
- 0.3% Retinol SR Complex
- Retinol 1% Night Complex
- Peptide CR Creme
- Peptide CR Eye Creme
- Acne Treatment Lotion
- You may continue to use products that do not contain the previously mentioned ingredients the day after your treatment
- Do not have any other facial treatments for at least one week after the procedure
- Use sunscreen with SPF 30 or higher daily and avoid direct sunlight for at least one week
At-home
To maintain or improve your results at-home, use the suitable Vivier skin care program recommended by your skin care specialist
If outdoor activities are planned use Vvier® SPF 30 or SPF 45
If you have any questions or concerns do not hesitate to contact your skin care specialist or your physician
