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    Melasma, mask of pregnancy

    How to treat melasma?

    Melasma is a very common skin problem found especially in Asian people (both women and men). It is a challenging problem for dermatologists worldwide because the complete cure is very difficult. Currently, there are so many varied treatments that patients are confused; Melasma Peeling cream, Hydroquinone, vitamin A, Glycolic acid, vitamin C, Arbutin, Glutathione, Dermabrasion, chemical peeling, the use of fruit acid in skin exfoliation.  There are also many types of lasers; Q-Switch ND Yag, Ruby, Alexandrite, IPL,Fractional laser.  There are too many varied treatments that patients are confused.

    Some patients were treated by almost every method but still not recovered or get better. Some people have darker melasma or redness, sensitive skin, irritation, unable to exposed to sunlight.

                With modern technology and the expertise of physicians, therefore it is important to choose the best for patient because individual patient has different needs and problems. Thus, the treatment cannot be the same.

     

    Treatment and prevention of melasma

    • The use of laser treatment to pull off skin pigment is the most direct way to treat. BSL clinic has more than 30-year experience with patients with melasma. Using laser to pull off skin pigment together with the transmission of substances that can stop the production of melanin and safe, in order to enhance the treatment and most importantly, prevent darker skin after the treatment.
    • Another laser therapy is the laser treatment which splits and dissipates pigment (Q -switch laser group). This will result in improvement during treatment but can cause white spots after treatment. If the treatment is stopped, spots tend to be darker. So, such treatment must be done continuously (non stop). Thus, our BSL clinic medical team recommends that this treatment is not the most appropriate and best treatment.
    • Using substances that can suppress the production of melanin and safe.  Products of Skinesia are effective in reducing melanin. This can stop the complete four phases of melanin process.
      • Inhibition of melanocyte activation
      • Reducing amount of tyrosinase
      • Cease melanocyte activation by inhibiting tyrosinase activity
      • Blocking melanin transfer into keratinocytes and able to lighten melisma by degradation of melanocyte and reduce melanin.​ 
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    • Use sunscreen products without chemicals every day to prevent new melasma. Choose a sunscreen with SPF 30 or higher and UVA PA +++ containing radiation reflective substance or vitamin E, which is the antioxidant, especially sunscreen without chemicals or Physical sunscreen that do not damage the skin.

     

    Before and after treatment pictures of a patient who has freckles and melasma problems with uneven skin tone.

    Before treatment photo:  a 45 year-old Asian female present with melasma on both cheeks for years. After treatment photo: treatment result after 4 laser treatment sessions.

     

    Before treatment; a patient with recalcitrant melasma on both cheeks After treatment: Treatment result after 3 laser treatment sessions

     

    Before treatment photo: a 42 year-old Asian female present with recurrence melasma on both cheeks for years After treatment: Treatment result after 4 laser treatment sessions

     

    Before treatment photo:  a patient present with recalcitrant melasma on both cheeks for years. After treatment: Treatment result one month after 1 laser treatment session.

     

     

    Before treatment photo: a patient present with mixed type melasma and acne blemish After treatment: Treatment result after 4 laser treatment sessions

    Article By
    Wipanee Akarapusit M.D. (Dermatologist)

    Specialize in Dermatologic Laser and Surgery, Facial Design and Body Contouring

    MSc Dermatology, Boston, Massachusetts, USA
    Specialize in Dermatologic Laser and Surgery, Facial Design and Body Contouring
    Member of American Society for Laser Medicine and Surgery

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