Melasma - Patients ask Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Melasma or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Melasma, often called the mask of pregnancy, is induced by hormones found in pregnancy and certain birth control pills paired with UVA exposure.
Melasma responds to topical fading agents. The chance of recurrence can be reduced only by meticulous use of a broad spectrum UVA filtering sunscreen.
Melanage peel can significantly reduce the pigmentation after only one treatment. Traditionally, microdermabrasion in conjunction with topical fading agents has also been very successful in the treatment of melasma. Peels such as glycolic acid or even Trichloracetic Acid can help but as solo treatments are inferior to the previously mentioned treatments.
|Skin layer affected||epidermis (upper most)||epidermis and upper dermis||Epidermis and Medium and deep dermis|
|Ease of treatment||+++||++||+|
|Ease of maintenance||Extreme discipline||Extreme discipline||Extreme discipline|
|Frequency||most common||less common||rare|
|Ethnic distribution||Mediterranean, Latino, Middle and Far Easten||Predominantly Far Easterns|
|Gender distribution||90% women||90% women||90% women|
|Melanage peel + kit||PicoSure® Focus Array||Microderma- brasion + topicals||Micro- derma- brasion||Q-switched Nd:YAG||FRAXEL||Topicals|
|Works on melasma types||1,2||1,2,3||1,2||1,2||2,3||2,3||1,2|
|Downtime||2-10 days||none||none||none||1 day||2-3 days||none|
|Time to results (months)||1||1-2||4||4-8||4||4||6-12|
|Preparation||none||none||1 month of fading agents before 1st treatment||none||none||topical numbing medicine||none|
|Risks||none||none||none||none||none||Paradoxical darkening of the treated area||None if used as instructed|
|Total Cost||Call for price||$2000||$850-$1200||$600-$1150||$800-$1600||$2400-$4000||$500-$1500|
The key in maintaining these results over time is to meticulously follow a post procedure skin care regimen for life.
Post melasma treatment always includes the use of a sunscreen. It must be applied daily, regardless of sun, cloud, rain or snow because UVA rays travel through anything including your car windows. It cannot just be any sunscreen but must be able to block or filter the entire UVA spectrum. If ever in doubt or you cannot find your usual sunscreen, use sunscreens that contain zinc or titanium dioxide.
If you are committed to a lifetime without melasma. Call us today to schedule a free melasma treatment consultation to learn which melasma treatment fits you best.
|Pigment suppression/ dispersion||Limitation of use||Source||Use during pregnancy|
|Sunscreen with UVA filter||+++||none||drugstore||yes|
|Hydroquinone 2-5%||+++||6-9 months, can be restarted after hiatus||drugstore (2%), prescription (4% and 5%)||no|
|Botanical fading agents||+++||none||physician dispensed||yes|
|Glycolic acid||+||none||physician dispensed||yes|
|Kojic acid||+||none||physician dispensed||yes|
|Mandeleic acid||+||none||physician dispensed||yes|