Melasma Cholasma Information Hampshire UK
The Disease Concept
- Excess pigment is made in the epidermis when you have melasma and, if the skin makes too much, it overflows into the dermis.
- Prescription-only creams remove pigment from the epidermis but only Fraxel laser treatments or Obagi Blue Peels will remove pigment from the dermis.
The Treatment Concept
- Light skin spills 10% of its melasma pigment into the dermis. Therefore, 8-16 weeks of intensive prescription-only cream treatment will remove most of the pigment.
- Darker skin spills 30-50% of its melasma pigment into the dermis. Fraxel laser treatments or Obagi Blue Peels, in combination with prescription-only creams, are needed to remove it.
What causes Melasma (Cholasma)?
Oestrogen, and sometimes progesterone, change the sensitivity of skin cells (melanocytes) that produce melanin so that the cells produce too much melanin in response to sunlight, friction, exfoliation or heat. It is almost as though these localised patches of skin start to tan too easily.
What happens if melasma (cholasma) is not treated?
Most people only develop melasma during pregnancy and the melasma improves once the extra hormones are cleared from the body.
However, some people who develop melasma while on the pill find that their melasma persists.
How can melasma (cholasma) be treated?
Melasma confined to the outer layer of the skin, epidermis, responds well to Obagi Nu-Derm. It is by far the best treatment I have used for melasma but it needs to be tailored to your skin type or it will make your skin very sore.
If you have light coloured skin and follow the regime meticulously every day, most of the pigment will clear in 8-16 weeks.
If you have dark coloured skin treatment takes longer and is more complicated. You will have to:
- Use prescription-only creams to remove the pigment in the epidermis.
- Undergo 3-5 Fraxel laser treatments or 2-3 Obagi Blue Peels to remove the pigment from the dermis.
- Continue on prescription-only creams for another 3-6 months after the last laser or Peel to prevent the skin from going brown again in a process know as post-inflammatory hyperpigmentation.
How can recurrences of melasma (cholasma) be prevented?
- Never go out in the sun without first carefully applying sunscreen or
- Continue with a modified version of the Obagi Nu-Derm
Treatments that waste money
- Microdermabrasion and superficial chemical peels only treat the epidermis which is better treated with creams that stop the pigment being made.
- Non-prescription creams. They are not as strong.
- Mixing prescription-only creams with your own cosmetic regime. The interaction of the creams prevent them from working as well.
Treatments that make melasma worse
- Intense pulsed light
