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What Is The Approach To Melasma Treatment?

Many people have the mistaken notion that Melasma is more of a nuisance than a problem. Nevertheless, they could not be farther from the truth. Melasma is a skin hyperpigmentation condition that can mar your looks and adversely affect your self-confidence. What is more worrying is, the condition is progressive and could get steadily worse. So what are some of the approaches we can consider for Melasma treatment?

Identify Melasma 

You should suspect Melasma if you notice discoloured patches on the skin, most commonly on the face. These brown to dark brown patches on both sides of the face stand out in contrast to the normal surrounding skin. The wide, flat darker patches on the skin are not painful or itchy at all. On the face, Melasma develops on the forehead, cheeks, nasal bridge, and chin. It can also develop on the neck and forearms – in short, areas that stand exposed to sunlight.

The skin's top layer or epidermis is home to cells called melanocytes, responsible for producing and storing melanin – the dark-colored pigment. When exposed to certain stimuli or triggers, patches of melanocytes tend to produce melanin in more quantity, resulting in unwanted pigmentation.

Fortunately, Melasma is neither cancerous nor an indication of the dreaded condition.


Treatment Melasma
Melasma Causes and Effects 

The problem affects more women, especially those who are pregnant, lactating, or on oral contraception. A detailed assessment and consultation play a crucial role in Melasma removal and control. This is because of the complex nature of the problem Melasma is a multifactorial skin pigmentation disease. As Dr Kenneth Thean, Medical Director at Ensoul Medical Clinic, explains, several factors or combinations can trigger Melasma to form.

Therefore, before exploring solutions, it makes sense to look at your Melasma's causes and dynamics.

An experienced doctor will look at your genetics as a probable cause of your skin pigmentation woes. In fact, several studies show that Melasma usually runs in the family. So, don't be too surprised when you realise that a good number of your family members are suffering from the same problem!

The extent or severity of pigmentation in each person also depends upon other several factors. Prolonged exposure to sunlight, or rather the Ultraviolet Radiation (UV) it contains, is a major factor in Melasma development.

Besides sunlight, hormonal imbalances have also been identified among the causes of Melasma among women, particularly pregnant and lactating women. No wonder, Melasma is also known informally as the "mask of pregnancy" or chloasma. Birth control pills and hormone replacement medicines are also potential melasma triggers under the hormonal category.

Ironically, there are also some treatments that could actually aggravate the condition leading to iatrogenic Melasma. The villains, in this case, can be chemical peels treatments or ablative laser procedures.

Melasma is typically a chronic condition that can last for long durations and is generally unstable, causing it to surface from time to time. Therefore, Melasma needs to be addressed with a regimen of long-term proper treatment and care. 

Melasma Treatment Simplified 

Clarifying that Melasma cannot be cured but only controlled, Dr Chiam Chiak Teng explains Ensoul Medical Clinic's 4-step approach to treating Melasma. It is an interesting approach to handling the challenge systematically -

  • The first line of treatment for controlling Melasma involves reducing the production of pigment by prescribing topical applications of medical-grade products and supplements. Over the counter (OTC) products work relatively slowly as compared to medical-grade products such as hydroquinone and may not be sufficient to clear the hyperpigmentation. OTC products only contain ingredients, such as Retinol, Alpha and Arbutin or traditional ingredients, that slow down the production of pigments in the skin cells.
  • The second stage of this approach involves using lasers to reduce the transfer of pigments from cells to the skin. These pigmentation laser treatments are used to target the transfer capabilities of the pigment cells. Low-intensity beams from these lasers are used for the laser toning procedure.  This is because high-intensity beams can stimulate the cells and lead to excess pigment production.
  • The third phase is meant for controlling hypervascularity. Here, yellow lasers are used to decrease the abnormal blood vessels situated under the skin, effectively controlling pigmentation production. Sometimes, oral medication is used to supplement this laser.
  • The last step in the process speeds up the pigment removal by using lasers such as the various Pico Lasers. The expulsion of pigmentation is achieved by breaking up the excess pigments into smaller particles with lasers. This is so that the body can flush them out much faster.
Although numerous laser treatments are available for treatment, every Melasma patient is different.

Therefore, not all lasers are suitable for every Melasma patient. At Ensoul Medical Clinic, the doctors skilfully combine customized multiple lasers treatment to effectively treat each patient's specific skin conditions. Basically, the Quad Laser uses a curated combination of multiple lasers to target the dermis and epidermis. As there can be more than one type of skin concern, the advantage of this treatment is that apart from treating the dark spots, the doctors can also help patients improve the overall skin quality and health – like making the skin brighter and thicker. There is zero to minimal down time. We also have other energy-based devices like pulsed radiofrequency microneedling as an alternative treatment for Melasma. Speak to our doctor to learn about your skin concern and find out which treatment is best suited for your Melasma.

Keep Melasma Away 

Post-treatment, beware of triggers and take adequate precautions. This is key to keeping Melasma at arms-length. Make sunscreen of at least SPF30 as part of your routine whenever stepping out, as sunlight (UV rays) is a big trigger for Melasma. Make a style statement while protecting yourself from the harsh sunlight with broad-brimmed hats. In addition, choose cosmetics and hygiene products that are gentle on the skin. Schedule a consultation at the Ensoul Medical Centre located along Orchard Road.