Malasma is a skin hyperpigmentation affecting the face and characterized by a typical localization also known as "mask of pregnancy" which makes it possibile to diagnose the syndrome. It generally shows up on the forehead, on the upper lip (in which case it resembles mustache) or on the cheeks, either concurrently of separately. Lesions usually develop in a gradual way but worsen after exposure to sun.
Although the diffusion of melasma is still unknown, it is estimated to affect 5-6 million women in the USA. Melasma is associated with any kind of skin, but tends to affect most frequently darker skin types. Approximately 90% of the women with symptoms of melasma are pregnant. The causing factors of melasma are still unknown but it is thought to be related to hormonal disfunctions as the syndrome shows up very frequently during pregnancy or in cases of women taking contraceptive pills.
What to do in case of melasma
In some cases, by simply removing the causing factors (for example interrupting the assumption of contraceptive pills) the disease may spontaneously regress within 1-2 years, especially if it is the case of superficial melasma. More frequently, instead, it endures and turns into a hyperpigmentation which gets hard to remove.
Superficial melasma is treated by means of whitening hydroquinone-based lotions, combined with pulsed-light sessions.
Deep melasma requires preventive therapy with depigmenting agents and the only technique capable of removing it permanently is fractional CO2 laser: it creates small 100-micron-diameter holes in the skin, which allow the elimination of pigments settled in the dermis.
It is strictly recommended, both in summer and in winter, to use a 50+ suncreen lotion with a higly selective filter against UVA rays, the ones most responsible for the persistence of melasma.
Melasma is a skin disorder with severe cosmetic consequences, characterized by hyperpigmentation localized especially in the face area. Topical hydroquinone and tretinoin had been considered the most effective treatment before the recent introduction of new techniques. The old methods still require a long period of treatment to get the skin whitened, not to mention annoying side effects.
Based on the principle of selective subcellular photodermolisis, ND:YAG Q-SWITCHED lasers with a wavelength of 1064nm go through the dermis and hit melanin, shattering it without damaging the neighbouring tissues.
The protocol used at Keiron Laser Institute consists in a skin analysis performed by the Miravex Antera 3D system and at least 5 treatments with low-fluence ND YAG QS laser every 1-2 weeks, associated with a specific pharmacological oral therapy for 8 weeks, which allows to reduce the risk of post-inflammatory hyperpigmentation after the laser treatment.
After completing the series of treatments to cure melasma, patients must be advised to keep extremely proctected by UV rays, which are the main cause of relapse. Maintenance therapies are also recommended at least once a year with "laser toning" sessions.