Chicago Cosmetic Surgery and Dermatology

Melasma

Melasma

What is melasma?

Melasma is a discoloration on the face which occurs due to sun exposure, heat and changes in hormones. It is also called chloasma or mask of pregnancy. It is a natural darkening of the skin caused by excessive production of melanin, the pigment that causes your skin to tan. 

Who gets melasma?

It can occur in the 2nd or 3rd trimester of pregnancy, in women who are not pregnant but on birth control pills or hormone replacement, in women with a history of melasma who have stopped external hormones, and sometimes in men. 

Treatments for melasma

There are a variety of agents and procedures that can assist in lightening of the skin, the most important of which is sunscreen. 

  • Sunscreens containing zinc oxide and titanium dioxide – these act as physical blockers to help shield the UVA rays (the ones that stimulate darkening of the skin) from reaching your cells. These rays, however, penetrate through window glass and clouds, making sunscreen necessary every day, even if you’re indoors or it is cloudy outside. The higher the concentration of zinc or titanium oxide, the better. Take a look at our sunscreen recommendations to find the best one for you. 
  • Hydroquinone – safely used since the 1960’s, hydroquinone can slow down the pigment production in your cells. CCSD Correct can be used twice a day to help lighten the skin while CCSD Correct + is only used at night and contains hydroquinone, a vitamin A retinoids, and a medicine to reduce inflammation. 
  • RetinoidsCorrect +, Retin A, Renova, Tretinoin, PCA Skin Brightening Retinol and Skin Better Sciences Alpha-Ret all contain vitamin A retinoids which have been shown to help exfoliate the cells which contain the pigment, while also decreasing inflammation. They are used nightly. 
  • Azeleic AcidCCSD Azeleic Acid 15% Gel contains this natural skin lightening agent which is also a topical antibiotic safe to use during pregnancy. 
  • Hydroquinone Free LightenersCCSD Correct Brightening Pads (use up to twice daily) and CCSD HQ Free Brightening Cream contain ingredients to block the formation of abnormal pigment. 
  • Antioxidants
    • Topical – Antioxidants, including vitamin C, help to calm free radicals which lead to further stimulation of pigment making cells. Products include PCA Pigment Bar, Avene A-Oxitive Water Cream and Neocutis Journee Bio restorative Daycream SPF30.
    • Oral – Vitamin C, E, Astaxanthin, Zeaxanthin, Pine bark extract(pycnogenol) are all potent antioxidants for promoting healthy, clear skin.
  • Procedures
    • PCA Peels – layers of lightening agents and exfoliating agents are custom applied to reduce brown spots and acne. Treatments typically result in mild flaking from days 3-5.
    • SilkPeel Microdermabrasion – a special lightening agent is instilled into the skin as the skin is simultaneously exfoliated, for a clearer complexion.
    • Fraxel 1927nm laser – Thulium lasers have been shown to lighten melasma in a series of 2-5 light treatments. Must use a lightening cream along with the laser. 

All treatments for melasma take several months to achieve an effect as the skin cycling process takes 28 days. If you are not seeing improvement after 4 months, please speak with us about additional treatments for you.