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What You Can Do About Melasma
Melasma typically appears as dark, irregular, well-demarcated hyper-pigmented patches on the face, usually seen on the upper cheek, nose, upper lip, and forehead. These patches develop gradually over time.  It is a common skin disorder in women during their reproductive years, and is often referred to as the “mask of pregnancy”.
The dark patches are caused by the overstimulation of the pigment producing cells in the dermis, called melanocytes, to produce more melanin when the skin is exposed to the sun. Experts believe that increased levels of female sex hormones estrogen and progesterone, combined with sun exposure, trigger hyperactive melanin production.
Pregnant women experience increased estrogen, progesterone, and melanocyte-stimulating hormone (MSH) levels during the second and third trimesters of pregnancy. Hormone related correlation is also seen with increased incidence of melasma in women taking birth control pills, hormone replacement therapy (HRT), and those with thyroid condition.
Genetic predisposition may also be a factor, just as race can play a role. Melasma is most common among women of Asian, Middle Eastern and Latin descent. There are also antiarrhythmic, antiseizure and antibiotic medications like tetracycline that may make the skin more prone to pigmentation after exposure to ultraviolet (UV) light. Certain cosmetic preparations have also been found to cause melasma-like patches on the face.
The discoloration usually fades away over a period of several months after giving birth or after stopping the oral contraceptives or hormone replacement therapy. Unfortunately, not all the discolorations disappear. Many also experience a resurgence of the patches after prolonged sun exposure.

Avoid the sun and 

use sunscreen daily. 

Prevention is primarily aimed at having daily facial sun protection and sun avoidance. Treatment requires the same regular daily sunscreen application, with minimum of SPF30 recommended. Wearing sunscreen daily should be a continuing habit even during pregnancy, while all other forms of treatments should be done after pregnancy.

The most common melasma home remedy is a combo of lightening and exfoliating ingredients. Years ago, the preferred lightening ingredient product was hydroquinone. Misuse of blends of hydroquinone and tretinoin have been the cause of many skin discolorations on the face, particularly those who failed to include sunscreen in their daily regimen. Risks associated with long term use of hydroquinone have also prompted most countries to restrict its sale. 
For sometime, kojic acid appeared to be the chosen replacement for hydroquinone, but doubts about its safety were raised prompting Japan and Korea to ban its use in cosmetic preparations. Now, we see the market embracing natural and effective skin lightening alternatives, like licorice extract, ellagic acid, and alpha arbutin, which are all found in DERMAX NanoWhite night essence, creams, and lotions. DERMAX Retinol C serum provides a more intensive effect with its micro-exfoliation feature.
In conjunction with home cream applications, in-clinic treatment options include chemical peels by TCA or a combo of glycolic and diamond peels. CollaWhite Collagenesis is a signature microneedling procedure at SkinStation designed to minimize skin discoloration and smoothen out rough skin. Multiple treatments, in combination with daily use of DERMAX UV MILK sunscreen, lightening and exfoliant creams, yield best results. To ensure that treatment doesn’t fail, sun exposure should be minimized.
Many doctors generally avoid IPL and laser therapy options for melasma. While it may work for some, many patients report a worsening of their skin discoloration. Those with melasma have excitable melanocytes that any exposure to light can trigger adverse effect. If your doctor recommends IPL or laser, ask for a second opinion.
This was published in the July 3, 2012 issue of Manila Bulletin Lifestyle Section. The author is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulations Commission (PRC) for his achievements in the field of cosmetic chemistry. He can be reached at (Updated on April 23, 2013.)

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