Laser Treatment

What is Melasma and how to treat it?

Melasma is a condition of the skin that causes discoloration of the skin in which gray or brown spots may develop on the skin. It may occur in anyone and is not harmful to the health, but it may lead to annoying cosmetic issues. Melasma generally involves sun-exposed areas of the skin, such as:

• Cheeks.
• Forehead.
• Upper lip.
• Chin.
• Other areas of the skin that are exposed to the sun.

Melasma may be present due to female hormones and is generally common in women who are pregnant or people who are taking hormonal birth control. Melasma may also develop due to genetics and certain medications.

Melasma is more prevalent in women than men. People with light brown skin and from areas of the world with intense sun exposure are at a greater risk of experiencing it.

Certain home remedies for melasma include:

• Applying aloe vera to the skin.
• Ingesting glutathione.
• Use of high-spectrum SPF sunscreen.

Most over-the-counter (OTC) lightening creams contain the skin-lightening agent, hydroquinone, which helps in preventing melasma. Other treatment options may consist of chemical peels. Doctors at Yashoda Superspeciality Hospital & Research Centre, Nehru Nagar, Ghaziabad, are always committed to providing you with the right information you may need about various health concerns. This article will help you in knowing more about melasma, its cause, diagnostic procedure, and treatment.

What are the causes of melasma?

Melasma occurs due to bad functioning of the melanin-producing cells, known as melanocytes, present in the skin due to which too much melanin is produced.

People with darker skin tones have more melanocytes than persons with lighter skin due to which melasma develops more in people with darker skin tones. Some of the factors that trigger the growth of melasma include:

• Due to changes in hormones during pregnancy (chloasma), hormone treatment, or taking pills for birth control.
• Exposing yourself to the sun.
• Certain skin care products, in case they irritate a person’s skin.

The genetic component also plays a major role in melasma development. People whose family or any close relative has experienced melasma are more likely to develop melasma in their lifetime.

What are the diagnostic procedures for melasma?

In most cases, melasma is easy to diagnose during a visual examination. But, a dermatologist may perform a small biopsy as melasma also resembles other skin conditions. The dermatologist may also use a device, known as Wood’s light, to look more deeply at the skin.

What are the treatment options available for melasma?

Some of the treatment options that you may opt for to treat melasma include:

• Skin-lightening agents- Skin-lightening agents generally consist of an OTC moisturizer or lotion. The active ingredient in these lotions is hydroquinone, which bleaches the skin by reducing the number of melanocytes present.
• Chemical peels- Chemical peels use acids and other ingredients like tretinoin and corticosteroids to eliminate the outer layer of the skin. Side effects, similar to a sunburn, may develop but once the skin recovers, melasma may be less prominent.
• Microdermabrasion- Microdermabrasion is a minimally invasive procedure that is performed by a licensed esthetician. In this, a tool with an abrasive tip or vacuum suction is used to slough off the outer layer of the skin.
• Combined creams- Dermatologists, in certain cases, may recommend combination creams that may consist of hydroquinone, corticosteroids, and tretinoin in one. These are known as triple creams.
• Additional topical medications- A dermatologist may prescribe azelaic acid or kojic acid which help in lightening the dark portion of the skin.
• Laser treatment- It may be considered when melasma does not respond to topical treatments and chemical peels. The risk of inflammation and hyperpigmentation is high in laser treatment. The trials followed in laser treatments are limited by small sample sizes.

What are the types of lasers used?

The types of lasers used to treat melasma may include:

• PicoSure- PicoSure is a laser that converts energy into pressure as opposed to heat. It functions quickly to treat melasma underneath the skin at its source. The procedure itself is less time taking and is slightly uncomfortable. You may feel a stinging sensation similar to that of a rubber band snapping on the skin. As per the study, PicoSure treats melasma without leading to side effects such as hyperpigmentation.
• Fractional- Through Fractional laser resurfacing, also known by the name, Fraxel, microscopic holes are made in the skin that stimulates the growth of new and healthy skin cells. You may feel a prickling sensation and generally topical anesthetic is given prior to the procedure. After the procedure, the skin looks raw and red or discolored. The skin will appear brighter, and more even-toned after 3 to 5 days of recovery.
• IPL- Through an Intense Pulsed Light laser (IPL), multispectrum lights of different wavelengths are targeted at certain colors in the skin. It is better to consult a dermatologist before undergoing this treatment as this treatment may make melasma worse in certain skin tones.
• Q- Switch- Through the Q- Switch laser, energy is delivered into the skin breaking melanin into smaller pieces, which are then eliminated by the body. Q-Switch may also bleach your hair, and you may feel a stinging sensation.

When are lasers recommended?

Lasers are generally recommended to those who seek long-term and quick results when other treatments, like lightning creams, have not been effective.

What are the side effects of laser treatment?

These are some of the side effects of laser treatment for melasma:

• Burning
• Potential for infection.
• Stinging
• Redness or discoloration
• Allergies to topical anesthesia

Some types of laser treatment have the tendency to make melasma worse by causing hyperpigmentation that develops generally on black and brown skin. You should always consult a doctor for deciding the best laser treatment you may require.

What happens during the recovery phase of laser treatment?

The following sensations may develop in the respective area after laser procedures:

• Itching
• Burning
• Stinging
• Red or discolored skin
• Slightly Swollen skin
• Blistered skin

The skin must be protected from the sun during the recovery process. Exposing yourself to the sun may make the treatment unsuccessful.

Wear high SPF sunscreens even on cloudy days to prevent melasma from worsening or returning after the treatment. You may also be advised to use skin-lightening treatment after the laser treatment.

When do you need to consult a specialist?

In case, melasma is still prevalent for several months after pregnancy or hormonal changes, or if you experience any pain or itching, you must consult a doctor. If even after a week of laser treatment, the skin does not heal, seek advice from the doctor. You may also inquire about when you must stop applying skin-lightening agents to prevent hyperpigmentation.

Laser treatments can be a better option for treating melasma when other treatment options are not helping much. Lasers permeate the outer layer of skin which results in cell renewal for brighter and more even skin.

In some cases, laser treatments for melasma may worsen the situation causing hyperpigmentation. It is always better to seek advice from a dermatologist about the best treatment you may need.

Need to consult a dermatologist in Delhi NCR?

The Department of Dermatology & Cosmetology at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad, is always ready to provide you with the best care you may need for all skin issues and illnesses. Our team of highly skilled and well-experienced skin specialists is always here to help you to maintain healthy and glowing skin using advanced technologies.

Dr. Anup Kumar Tiwary has done his MD in Dermatology from Rajendra Institute of Medical Sciences, Ranchi, and has an award in national observership and fellowship in Dermatology, Hair Transplant, and Laser MIADVL. He is highly skilled and proficient in the field of Dermatology and Cosmetology. He is highly trained in cosmetic procedures such as PRP therapy, botulinum toxins, fillers, and lasers for different skin and hair problems. He has also given oral and poster presentations at international and national conferences.

Dr. Guncha Arora Mohan has a medical experience of more than five years at Yashoda and is a highly skilled dermatologist and venereologist. Her proficient areas include clinical dermatology, acne, acne scar surgeries, and cosmetology procedures such as peeling, lasers, RF, anti- ageing procedures, paediatric dermatology, and venereology.

Book an appointment at Yashoda Superspeciality Hospital now. Visit our official website: www.yashodahealthcare.com