Melasma in Dark Skin Types

Melasma / Pigmentation In Dark Skin Types

People of color are a very large group, which in South Africa includes people of African and Asian descent. It also includes patients of mixed backgrounds who have more darkly pigmented skin. Darker skin type people represent a significant and growing group of patients seeking aesthetic procedures. This is because of the increased awareness of safe, affordable aesthetic procedures. These procedures include amazing new lasers that are colour blind and are less invasive than previous generations of lasers. Yet special concerns have to be addressed when treating skin of color.
Melasma, also known as hormonal pigmentation, is a considerable problem for South African women especially in darker skin types. It is a chronic skin condition that occurs on the face in the form of brown patches and is a dynamic (active) condition that needs lifelong management.

What causes Hormonal Pigmentation/Melasma in dark skin types?

•    UVA rays are a stimulant for melanin (brown pigmentation) to develop on the skin, and unfortunately can even penetrate through car window glass.
•    any change in hormonal status with higher levels of estrogen is thought to trigger and aggravate the condition (i.e. birth control pills and pregnancy).Discontinuing the use of contraceptives rarely clears the pigmentation and it may last for many years after discontinuation.
•    After pregnancy Melasma (chloasma) or pigmentation  usually clears within a few months of delivery but may persist indefinitely
•    however many women without these risk factors also develop melasma
•    any activities that cause Intense heat to the face( from steam showers, hot closed environments, sitting on the beach even under cover and with full sun protection,  etc causes inflammation which is a powerful stimulator of melanin
•    It is more prevalent in darker-complexioned individuals though persons of any race can be affected due to the intense sun exposure in South Africa.
•    Melasma is seen most frequently in young women but can be seen in men

Where does Melasma appear on the face?

•    Centro Facial (forehead),
•    Malar (cheekbones) and
•    Mandibular (jawline).

How can one prevent Melasma from forming in darker skin types ?

•    Avoid sun exposure and wear a protective hat when outdoors for extended periods to further block these rays.
•    Use a a broad-spectrum sunscreen  with SPF 30+ to block the UVA rays  every day to help prevent melasma.
•    In addition your sunscreen should also contain an anti oxidant as this stops free radicals which cause pigmentation.
•    At least 10  mls of sunscreen should be applied daily to the face and neck twice a day to prevent melasma.
•    Taking an oral anti oxidant supplement such as  Pycnogenol from the French Maritime Pinebark  is clinically proven to raise one’s level of resistance to the sun and also helps to reduce the melanin content in the skin down the line.
•    As melasma is a dynamic condition and needs to be manage daily and indefinitely. One day of unintentional sun burn can set you back.

What are the different  types of Melasma in dark skin types ?

(This describes how deep the pigment is in the skin and how to treat it)
•    Epidermal melasma is the most common form and is easily treated with a combination of superficial chemical peels and Limelight  procedure ( not in Skin T ype 6)
•    If the melanin has leached into the dermis, this is known as dermal melasma. The deeper the pigment is and the more difficult it is to treat. Dermal melasma is not treated with superficial peels and is best treated with the Laser Genesis procedure  which can penetrate into the dermis to reach the pigment.
•    Mixed Epidermal-Dermal is a combination of the above and needs full thickness epidermal peels such as Chemibrasion combined with long term Laser Genesis treatments

Home therapies  for Melasma in dark skin types:

At Skin Renewal we offer traditional topical home therapies such as AHA s, PHA s, Arbutin,  Kojic Acid and Hydroquinone to treat age spots. However hese traditional products try combating age spots with disappointing results or worse - cause hypersensitive skin, which in turn aggravates the pigmentation
The traditional way to treat PIH and melasma has been to bleach the darkened pigment using hydroquinone based products, whether over-the-counter or prescription.  Still, despite best efforts with bleaching agents and exfoliation treatments , pigment from melasma can be stubborn and long lasting. There is a ‘something’ missing in conventional fading creams. Most have side effects. For most people with dark skin, treating pigmentation t is like taking one step forward and one step back. The challenge is to take care of dark skin, fade the dark spots and heal it without scarring
Skin Renewal is pleased to be able to offer the “ something” missing in conventional fading creams .These are  recent advances in pigmentation technology such as the recently launched  Brighter Concentrate and Luminesce  range by Lamelle.
Properties and benefits of Luminesce and Brighter Concentrate by Lamelle :
•    Luminesce and Brighter Concentrate can be safely used in all skin types and will not cause the sensitivity that is associated with traditional lightening/fading creams.
•    Brighter Concentrate and Luminesce, offer advanced pigmentation programs which age spots by reducing melanin at eight  points in its production, as opposed to just one point as with other traditional lightening  treatments. Brighter Concentrate used twice daily for 8 weeks will reduce the appearance of age spots and is safe for use on all skin types unlike traditional skin lightening cosmeceutical products as well as prescription medications.
•    An added benefit is that the combination of peptides used in the range offers anti-ageing benefits to the skin as they stimulate collagen producing cells.

In Office therapies for Melasma in  dark skin types:

At Skin Renewal we emphasise that home lightening products such as Lamelle Brighter Concentrate must be used routinely for 2 weeks on the entire face before any exfoliation treatment such as peels.

Beta Hydroxy Peel:

With a series of Beta Hydroxy Peel s you can quickly achieve substantial improvement in the uneven pigmentation, while making your skin look and feel softer, smoother, and more radiant. Suitable for all skin types

LimeLight:

improves any epidermal pigment in Type 5 skin . This treatment cannot be done on Skin Type 6 ( black skin) The LimeLight procedure   can b customized to your skin type and selectively treat the  brown pigmentation of melasma in the epidermis . Immediately after the treatment, brown spots will start to darken and your skin may be slightly red. Within one to three weeks, the darkened spots will flake off and fade.

Laser Genesis:

The epidermis renews itself every six weeks, by six months, any pigment from Melasma  is probably in the dermis. Traditional skin rejuvenation treatments such as peels, microdermabrasion and bleaching agents are not successful for pigment such as melasma that has leached into the dermis. That is when the use of certain lasers such as the long pulsed Nd Yag become effective to safely treat darker skin including skin type 6.  The Laser Genesis procedure by Cutera gently heat the dermis, causing cavitation bubbles, which disrupt the unwanted dermal pigment, breaking it into smaller particles which are able to move upward to the epidermis where it can be easily removed with exfoliation .

Transdermal mesotherapy:

with Brightening meso &  Brighter Concentrate  uses peptide technology to  reduce melanin at eight  points in its production, as opposed to just one point as with other traditional lightening  treatments.

10 %  TCA overlays

in Skin Type 5 & 6 increases the penetration of  peels and helps  lift resistant pigment

PDT Red Light

post peel reduces inflammation and evens out skin tone.

Chemibrasion ™

is an innovative non-invasive rejuvenating treatment mask peel concept that adds a new dimension to professional superficial peeling with the added benefits of rejuvenation and restoration without aggression or negative side effects and can be used in all skin types

Mela T  ® peel

is a full epidermal peel for hormonal pigmentation  (Melasma) that is resistant to treatment with normal superficial AHA and BHA peels and contains: Lactic Acid, Salicylic Acid, Citric acid, TCA and Vitamin A in the form of Retinoic Acid Skin Type 1 to 5 only

Is treatment for Melasma in Dark Skin Types available at all Skin Renewal branches ?

Treatment for melasma in black skin is available in Johannesburg, Sandton, Pretoria and Cape Town at the Rivonia, Parkhurst, Sandton, Fourways, Irene, Cpae Quarter, Claremont and Willowbridge branches

Skin Renewal Tip:

People of colour who are looking to treat hormonal Pigmentation / Melasma with lasers or lights would be well advised to consult with a medical doctor with experience in treating skin of colour to prevent unwanted effects such as full thickness burns, permanent scarring and post inflammatory hyperpigmentation.  At Skin Renewal hundreds of Patients with dark skin types have been treated for hormonal pigmentation . If the above recommendations and treatments are followed virtually any patient can be a candidate for a lightening of their pigmentation. However melasma is a dynamic condition and one day of unintentional sun burn can set you back.