Melasma Freckles are common problem in which there is an increased production of brown pigment (melanin) that occurs in sun-exposedareas of the face. It affects mostly women most of which are of child bearing age. However, up to 10% of cases have bee reported in males. While all races are affected, there is a prominence among Latinos and Asians. Melasma is more apparent during and after periods of sun exposure and less obvious in winter months, when sun exposure is lacking. Melasma Freckles is often present on the cheeks, upper lips and forehead and sometimes occurs on the forearms. It looks like brown patches of skin which can sometimes cover the entire face,giving a mask like appearance. Not only can this mask affect how others see a patient with Melasma, it can affect how patients with Melasma see the world. Anxiety and depression are more common in patients with Melasma.
Causes of Melasma has been considered to arise from pregnancy (giving rise to the term, “mask of pregnancy”), oral contraceptives, endocrine dysfunction, genetic factors, medications or cosmetics and other factors. The majority of cases appear related to pregnancy or oral contraceptives. Sun exposure does appear to be a stimulating factorin predisposed individuals.Up to a third of the occurrences in women are not preceded by any specific condition.
Melasma is very difficult to treat, and even harder to cure. It usually requires a combination of lasers, topical bleaching medicines, strict sun avoidance and daily sun block. When medicines such as birth control pill are the cause they generally have to be discontinued to see long term improvement. One may see their melasma clear with therapy, but flare during the summer months after sun exposure and this may require additional maintenance treatments. Treatment Melasmaologies for Melasma Used In the Clinic of top and best dermatologist Islamabad Pakistan skin clinic.
> Fraxel Laser
> Q Switch Laser
> KTP Laser
> Topical Bleaching Medicines
Using the Fraxel laser’s unique approach of using millions of microscopic thermal spots to gently resurface only portions of skin at a time; we now have the ability to penetrate deep enough into the skin to eliminate the skin cells that cause melasma while protecting the skin’s outer layer. FDA clearances for the Fraxel laser include skin resurfacing treatment of sun damaged skin, acne scars and melasma. For melasma, Fraxel laser treatments are performed after every 7-10 days for a month or two. Sun avoidance and the use of a high grade UVA and UVB sun block is essential at all times.
The laser at a wavelength of 532 nm is used for tattoos, sun spots, nevus of ota, caf-au-lait, and melasma. The laser can penetrate and target melanin in the deep dermis, making it another option for the treatment of melasma. This procedure is provided in a series of monthly treatments . Sun avoidance and the use of a high grade UVA and UVB sun block is urged.
This laser is used to treat freckles and epidermal or superficial melasma. It causes small wounds on the area being treated.
These areas start crusting after a few days and start regaining the normal skin color after 3-4 months.
Treatment regimens include the use of a sunscreen with a minimum of SPF 40, bleaching agents such as kojic acid, licorice extract, rucinol, vit c, anti-oxidants,retinoids such as Retin-A and a prescription product which combines a retinoid, bleaching agent and cortisone. Retinoids work by promoting the rapid loss of pigment by increasing skin turnover and easing penetration of bleaching ingredients into the skin. Azelaic Acid, Mandelic Acid and Kojic acids are types of alpha hydroxy acids (Peeling Agents) which are also commonly used. Glycolic acids have to be used with great caution in patients with darker skin types due to potential side effects. No matter what treatment regimen a patient follows, the use of a broad spectrum sun screen is mandatory. Unfortunately the only type of Melasma that may respond to topical therapies is mild, epidermal melasma, and this may take a minimum of 3- 6 months to work. The more common form of Melasma affects both the epidermis and dermis and for this variety, topical treatments are generally ineffective. Various laser treatments may be used to treat melasma including the Fractional laser and Q-switch laser.
What happens to the skin after treatment?
The area may become pink or red with a bit of swelling but that subsides within
a couple of hours.
What should be done after treatment?
Following treatment, you can return to your normal activities. Avoid: Retin-A, alphahydroxy
acids, glycolic acids, and astringents. You may clean the area using mild soap and
water. You should avoid tanning and use a sunscreen on any treated areas exposed
to the sun.
What should be expected?
Around 3-10 days after treatment, hair will begin to surface.
Most of these hair
were treated and are “falling out.” It is not regrowth. The hair follicles need
to purge the hair that remained under the skin. PLease refrain from waxing, plucking
and bleaching between treatments. (shaving is ok)
Dose a long pulse Nd Yag work on all skin types?
Yes, it can be used on all skin types. However because it is an Nd Yag laser rather
than an IPL device, it is ideal for individual with darker or tanned skin. We can
provide effective results in fewer treatments more safely. The risk of superficial
burns is greatly lessened, virtually eliminated.
Is permanent hair reduction possible for blonde or light hair?
Because it contains very little pigment, blonde or light hair is difficult to treat
effectively with any laser or IPL system. We can get some reduction, but it takes
many treatments to achieve any meaningful results.
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