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Managing Melasma


Melasma before & after

Understanding Melasma

Melasma is developed through the migration of melanocytes into groups; This bunching effect is meant to protect fragile areas from premature aging but the outcome is aesthetically undesirable as they look like age spots on the skin but occur at a younger age. Studies on melasma are still in their infancy however it's believed to be caused by an imbalance of estrogen or progesterone hormones


To understand melasma we need to understand melanin and the cells it consists of known as melanocytes, the critical first-line of defense for our skin. Melanocytes suffer more DNA damage than any other cell in the body due to their superficial location. As soon as we step into the sun free-radical damage begins, which triggers melanin production to adapt & protect skin from UV light. Melanocytes age over time, our bodies replace them with stem cells that mature into new melanocytes. This process repeats throughout our lifetime. Melanocytes live for years whereas skin cells only live for 28 days which helps us understand how we can develop melasma despite the skins ability to exfoliate itself


Melasma has become a commonly seen condition over the years; Statistics show 1 in 15 women in the United States and 1 in 3 women in Asia have this undesirable affliction. Anyone can develop melasma however it's seen most in pregnant women and women who take oral contraceptives. In fact 1 in 3 women who take birth-control pills have melasma


Melasma sometimes lightens as hormone levels balance post birth-control methods or postpartum however at least one-third of those suffering from pregnancy-induced melasma and two-thirds of those who stop birth-control pills continue to have symptoms


If you biopsy melasma you’ll see nothing other than hyperpigmentation in the affected areas. It looks identical to biopsies of sun damage, injury or prolonged inflammation so theoretically it should lighten using any methods that are successful treating these types of pigmentation however it is caused by hormonal imbalances so if those aren't addressed the melasma will likely redarken quickly


Research has also found that underneath areas of melasma we find a build up of toxins that create nutrient deficiencies in the skin which lead to inflammatory pigmentation development. In the non-afflicted areas we find healthy skin, with a normal allotment of nutrients. Products that contain high amounts of antioxidants help reverse this toxicity. Antioxidants have about an 8 hour lasting effect when applied topically, which is why its recommend to apply them morning & evening


Dermal Inflammation is another potential cause of melasma. Data shows clients with sensitive or red skin tend to develop melasma as they mature. The body does this to protect sensitized areas from further aggravation as melanated skin is more resistive to sun damage and the free radicals in UltraViolet light are attracted to the darker pigment which protects the underlying cells from being damaged


Managing Melasma

Melasma can be difficult to treat due to its unknown origin, possible relation to hormones and its sensitivity to UV exposure. It's normal to see melasma in pregnancy and while using hormonal birth-control methods; there shouldn't be any attempts to lighten the pigmentation during this time as any efforts to do so will be unfruit. One should wait until after the delivery or cessation of birth-control methods and hormones have had time to stabilize over the following months


Topical remedies for melasma such as antioxidant melanocyte suppressants and chemical peels can be very effective, but not always. Women who experience this condition without use of hormonal medications or being pregnant often experience recurrence by their next menstrual cycle. Chemical Peels are the only treatment method proven to destroy hyperactive melanocytes, but not all individuals are a candidate for a chemical peel, speak to your esthetician or dermatologist for appropriate options


The antioxidants in most products are unable to reach the lower epidermis, however those that contain liposomal antioxidants such as niacinamide feed skin with increased blood flow; and 1,3 beta-glucan, which triggers macrophages to come in and remove toxins that are blocking nutrient delivery


Some cases of melasma respond well to antifungals like caprylic acid which leads to a theory that internal yeast imbalances can also contribute to the onset of melasma. As hormone levels rise yeast becomes more prominent in the gut and on our skin. Pregnancy and birth-control pills increase hormone levels thus increasing yeast population which explains why even after pregnancy or anti-conception methods melasma often remains as the abundance of yeast has yet to be addressed and is continually fueled by imbalanced diet, lifestyle and or medications


Living with Melasma

Knowing dermal inflammation can lead to melasma it's highly advised that those prone to its symptoms avoid the sun and under no circumstances have any prolonged exposure to UV light. Zinc based sunblocks have been proven to help regulate excess melanin production so it's an ideal ingredient to look for when selecting an SPF, avoid sunscreens as they contain toxic, cancer causing chemicals such as titanium dioxide


Avoid treatments that yield results via an inflammatory response that don't include melanin suppression as a benefit. Lasers should be completely avoided as they tend to inflame the skin and worsen melasma


Hydroquinone is often recommended by estheticians and dermatologists but long term it causes more inflammation & sensitivity while also making one more likely to develop skin cancer... Lightening agents such as retinoic acid (retinols), glycolics and BHA's (salicylic acid) should also be avoided as they ultimately speed the skins aging process by reducing overall melanin in the skin which is needed for adequate protection. Lighteners have no DNA corrective properties and must be used indefinitely for an ideal outcome. It's better to focus on ingredients that repair & restore skin cells. There are many botanical that lighten melasma without adding inflammation to the skin: alpha-arbutin, bearberry, gamma aminobutyric acid (GABA), paper mulberry bark, sepiwhite, tetrahydrocurcumioids and watercress extract for example


Summary

Melasma is often indefinite but can be managed and in some cases completely desquamated. Avoid harsh / inflammatory products, treatments and UV exposure. Wear sunblock, not sunscreen and use liposomal delivered antioxidants. Wear a melanocyte suppressant like the one featured below and consider including regular Chemical Peels into your management plan



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