Melasma, also known as a pregnancy mask, is a pigmentation disorder in which pigment spots appear on the face. The pigment spots are often visible as an irregular light brown to dark brown discoloration. It often occurs on the cheekbones, upper lip, chin and / or forehead.
The cause of melasma
The exact origin of melasma is still unknown, but there is a link between sun exposure and pregnancy, pill use, certain medication and hereditary predisposition. The hormones estrogen and progesterone stimulate the production of pigment under the influence of the sun. For this reason, melasma is also called pregnancy mask. During pregnancy, these hormones in the body are elevated, which can cause melasma.
Types of melasma
There are 3 types of melasma:
- Epidermal, there is an increased pigment in the top layer of skin.
- Dermal, the pigment cells ‘leak’ pigment to the dermis (dermis). The immune cells that are present in this layer of skin encapsulate the pigment. As a result, the pigment remains in the dermis and cannot go to the top layer of skin to exfoliate.
- Combination epidermal and dermal, there is often a combination where the pigment is present in both the top skin layer and the dermis.
Treatment of melasma
The treatment of melasma in 4 steps.
- Preparation of the skin for the peels
- Peelings in the clinic
- Fractional Erbium-YAG laser (2940nm)
- Continuous use of the recommended home products
1. Preparation of the skin for peels
Before the peels in the clinic, the skin should always be prepared with the right home products. This ensures that the condition of the skin improves so that the peeling has more depth effect.
2. Treatment of melasma with peels
3. Treat melasma with the fractional laser
For dermal (deeper) pigment, we treat after the peels with the fractional Erbium-YAG (2940 nm). This laser creates many tiny holes in the skin, so that the pigment cells are, as it were, pierced and start to reorder. The excess pigment is destroyed and removed. The skin will flake after this treatment. The laser works ablatively, which means that the top layer of skin evaporates and a recovery time of 3-5 days is required.
On average, 1-3 treatments are required for a desired result with an interval of 4-6 weeks.
4. The right products at melasma
For the result and the maintenance of the result, the right home products are just as important or even more important as the treatments in the clinic. The pigment cells in melasma are hypersensitive to sunlight. As the skin comes into contact with sunlight (always when you walk outside), the pigmentation process in the skin will start. This process of pigmentation is much more active in melasma. It is important to use products with active ingredients that have an inhibiting effect on all the following steps of the pigment process:
Blocking of UV rays
Blocking MSH (melanin / pigment stimulating hormone) before it can signal the pigment cell.
Suppressing the tyrosinase process. During this process, the pigment cells start to produce pigment. The active ingredients ensure that less pigment is produced.
Regulate the release of the pigment to the top layer of skin
Initiate exfoliation of the top layer of skin
The best results can be achieved if products are used that affect every step during the pigmentation process in the skin. We recommend the products of Dermaceutic and SkinCeuticals. The skin therapist can advise you on this during the consultation.
Due to the high sensitivity of the pigment cells to UV rays, melasma remains a difficult (chronic) indication. The peels and the laser treatments treat the pigment process and the excess pigment present, but not the (hormonal) cause of the melasma. For this reason, the use of the correct care products is very important for the duration of the result and maintenance treatments are desired.