As I mentioned in a previous blog, melasma is a chronic skin disease characterized by the appearance of brown spots on the face. The appearance of this type of spots is due to a hypersensitivity to sunlight, and to a lesser degree due to white light and heat.
When we began a melasma treatment , we need to take into account several factors:
- The patient and their skin type: The treatments vary depending on whether the skin is sensitive or if there is some kind of intolerance to any of the ingredients that might be used in the treatments.
- General conditions such as pregnancy: During pregnancy, for instance, we should avoid several creams and treatments such as chemical peels, laser and pulsed light.
- The length of time since the melasma appeared: As time goes by, the spots become deeper and this makes it more difficult to make them clearer.
- The type of work/activities the patient performs: If the patient is usually out in the open air, the treatment would be more difficult.
- Whether or not the patient has undergone previous treatments. Sometimes the spots become deeper due to treatments that produce inflammation.
If you want to get ride of melasma successfully, you have to have in consideration this 2 equally important factors:
- Sun protection: It’s very important to understands “the sun is the main reason why the spots appear”; not only the direct, intense sun, but also the simple sunlight that filters in through windows, the sunlight on cloudy days or even when you are under the shade. It is for this reason that care must be taken and a sun protector of at least SPF 30 should be used every 4 hours while there is sunlight. Also, physical protection such as a hat, cap or umbrella should be used. Unless these measures are taken the treatments would not work.
2.Treatments: All the treatments consider the use of creams, which can be used by themselves or mixed with alternative treatments such as chemical peels, laser or pulsed light. Also, creams containing hydroquinone should be used preferably at night because they become oxidized in the sunlight, and this decreases their effectiveness.
There are several other substances that help with spots that can be used depending on each of the factors previously mentioned. Approximately 50% of the patients react satisfactorily to the creams, while the rest need to mix this treatment with chemical peels, laser or pulsed light treatments..
Laser or pulsed light treatments should only be used for extreme cases, and after a very careful assessment, because they can cause severe inflammation and generate inflammatory spots which increase even more the pre-existing conditions of the patient.
Melasma treatment require several months in order to be effective and it’s important that you have in consideration, that you will need to use sun protector per life to prevent the spots from coming back.
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