Pigmentation
Pigmentation on the face or body can be distressing. Pigmentation on the face is known as melasma or cholasma and looks like symmetrical brownish blotchy areas. It is caused by overproduction of melanin from the pigment cells in the skin. It mainly affects women between the age of 20 to 40 and affects those with tanned skin more than lighter skin.
Melasma has various causes and a complex aetiology:
Genetic: One third of sufferers report having family members that also have melasma.
Hormonal: Pregnancy can induce melasma, as can taking the oral contraceptive pill. Patients will be advised to stop the contraceptive pill to see if the melasma fades. Melasma often fades after pregnancy.
Sun Related: Exposure to ultraviolet light deepens the pigmentation in melasma due to stimulation of melanocytes which are the cells responsible for pigmentation in the skin. Sunlight is the most important avoidable risk factor in melasma. A high factor SPF 50 should be applied (and reapplied) to the face everyday to avoid stimulation of pigmentation and melasma due to sun exposure.
Obagi NuDerm to correct hyperpigmentation
What treatments are available for melasma?
Melasma can be difficult and slow to treat. Successful treatment can be quickly reversed by too much sun exposure that can cause the pigmentation to return. Any treatment programme will include avoidance of excess sunlight exposure and will require daily use of a high SPF sun factor to the treated area, preferably an SPF 50.
Topical creams can be used to treat melasma. Dr Zein Obagi, a Consultant Dermatologist has designed a prescription only skin care regime called NuDerm that treats melasma by using hydroquinone 4% as the active ingredient. It is an 18 week treatment programme and needs to be prescribed and overseen by a Doctor. It is very successful in treating melasma in all skin types. Side effects include some skin redness, irritation and dryness. For more information on Obagi products click here.
Other topical creams to reduce melasma include kojic acid, azelaic acid, ascorbic acid (Vitamin C), arbutin and liquorice extract. Salicylic acid chemical peels can also be used to treat superficial pigmentation with good success.
Are there any treatments for freckles and sun/age spots?
The same treatments that are used for melasma can be used to treat freckling and age spots on the face. In addition, Intense Pulsed Light (IPL) can be used to break down sun/age spots on the face and body. Several treatments may be required spaced out every 4 weeks. You will be asked to avoid any sun exposure during treatments. Sun avoidance and high SPF sunscreen daily to the face and body will prevent sun spots and freckles from returning. Your Clinician can advise you further during your initial consultation.
