Clinical Home Care for Melasma Pigmentation Management

Updates and Advances in Melasma (Pigmentation) Treatments.

Melasma is a problematic pigmentary condition that is often hormonally influenced. It is a chronic condition that occurs on the face, with uneven patchy brown pigmentation over sun-exposed areas. It is a chronic and active condition that requires long-term care and management.

While the pigmentation can be reduced with chemical peels, lasers and other light treatments [see our post on procedure options], long-term care often requires attention to avoidance of excessive sun exposure, harsh chemicals that may cause skin irritation, and countering the effects of UV damage and the formation of free radicals.

Recent research finds that even exposure to light in the visible light spectrum (not just ultraviolet UV light) can worsen pigmentary disorders. [see research footnote]

UV exposure is the major aggravating factor or trigger in the development of melasma and other pigmentary disorders. But recent evidence suggests even visible light triggers hyperpigmentation in darker skin individuals (Fitzpatrick type IV-VI).

Clearly, better protective agents and strategies are required, to minimise the effect of the UV, infrared and visible light that reaches the skin, as well as reducing the harmful effects of inflammation that it causes.

Recent research has given us new agents to aid in long term maintenance, and minimise recurrence of melasma after initial treatments. For daily long-term care before, during and after clinic treatments of your melasma, we recommend:

  1. the use of a topical broad spectrum SPF 50+ sunblock - a teaspoon (approximately 5ml) of sunblock should be applied twice a day to the face, neck and exposed chest area (decollete).
    • LaRochePosay Anthelios (available in fluid, gel and cream formulations), or
    • Skinceuticals Sheer Physical or Physical Fusion (a physical sunblock for sensitive skins)
  2. Topical anti-oxidants with Vitamin C, Vitamin E, Ferulic acid and phloretin that protects against UV and infra-red spectrum light.
    • Skinceuticals Phloretin C or Skinceuticals CE Ferulic serum 
  3. Topical pigment correcting product such as Cysteamine Cream® which is a novel pigment corrector for hyperpigmentation concerns. Naturally present in human cells, cysteamine reduces melanin in the skin epidermis, effectively removes brown spots, reduces pigmented marks and produces a uniform and light skin complexion.

  4. Oral anti-oxidant
    • Heliocare is a oral tablet form of Polypodium Leucotomos extract, from the central American fern, has strong antioxidant, anti-inflammatory and immune effects. It is clinically proven to raise the skin’s resistance to sunburn, sun damage, and reduces the formation of harmful metalloproteinases that cause pigmentation and skin-aging. Daily use is recommended for patients with melasma, and 1-2 hours before sun exposure, in addition to topical sun-screens. [see research footnote].
    • Another antioxidant available in tablet form is Crystal Tomato®, it contains Carotenoids which have been scientifically proven to produce many benefits for the skin such as healthier, more radiant complexion, the supplement is not only a safe and convenient way to beautiful skin but has also become a must-have for maintaining and protecting skin quality. In a clinical trial carried out at National Skin Centre of Singapore, a combination treatment of Crystal Tomato® supplement and Skin Clarity Cream showed significantly better results than the industry’s most well known whitening agents.
  5. Avoid hot baths, steam or dry saunas, hot yoga that may cause excessive inflammation.
  6. Wear a broad-brimmed hat when outdoors. This has the added benefit of looking extremely fashionable.
  7. Hormone balancing treatments may be required for patients experiencing hormonal fluctuations around the menopause, and for patients taking hormone treatments (e.g. oral contraceptives), and this should be discussed with our doctors.
 
 
 Cysteamine Cream

References: 

  • Nestor M, Bucay V, Callender V, Cohen JL, Sadick N, Waldorf H. Polypodium leucotomos as an Adjunct Treatment of Pigmentary Disorders. J Clin Aesthet Dermatol. 2014 Mar;7(3):13-7.
  • Gonzalez S1, Alonso-Lebrero JL, Del Rio R, Jaen P. Polypodium leucotomos extract: a nutraceutical with photoprotective properties. Drugs Today (Barc). 2007 Jul;43(7):475-85.
  • Gonzalez S1, Gilaberte Y, Philips N. Mechanistic insights in the use of a Polypodium leucotomos extract as an oral and topical photoprotective agent. Photochem Photobiol Sci. 2010 Apr;9(4):559-63.
  • Mahmoud BH, Ruvolo E, Hexsel CL, Liu Y, Owen MR, Kollias N, Lim HW, Hamzavi IH. Impact of long-wavelength UVA and visible light on melanocompetent skin. J Invest Dermatol. 2010 Aug; 130(8):2092-7. Mahmoud BH, Hexsel CL, Hamzavi IH, Lim HW.
  • Effects of visible light on the skin. Photochem Photobiol. 2008 Mar-Apr; 84(2):450-62.