PS from the PA – November 2022

Hamilton DermatologyNews

Melasma. One of the most challenging skin conditions. The darkening of the skin on the upper lip, cheeks, forehead, and even arms can be horribly frustrating once it makes its appearance. Unfortunately, we have not yet found a cure; however, we have been actively studying new methods of treatment and prevention including lasers, chemical peels, oral and topical medications.

While it is not entirely clear why this occurs, some sort of inflammatory trigger causes the melanocytes, the cells that produce pigment, to turn into overdrive. Most seen in women ages 20-40, increases in hormones such as estrogen and progesterone, due to oral birth control pills or pregnancy can trigger melasma to develop. Other triggers include sunlight exposure, heat, and stress. While some cases of melasma can fade on its own once the offending agent has been resolved, it can often last for a lifetime. Melasma is not dangerous, but it can often cause uneven skin tone causing patients to seek treatment options.

Since this skin condition can be chronic in nature, often most treatment regimens include avoiding triggers. Since sun exposure is a common culprit, shade and sunscreen are encouraged. Not just any sunscreen will do. Ingredients to include are zinc oxide, titanium dioxide, and iron oxides. Simply put, get a TINTED MINERAL sunscreen. This will provide the broadest spectrum of protection, including exposure from our screens and lightbulbs. Since this is an inflammatory process, taking supplements such as niacinamide or heliocare can suppress inflammation throughout the body, thus reducing melanocytic effects.

Reversing options include topical agents such as hydroquinone, vitamin C, azelaic acid, kojic acid, and retinoids. Not all these ingredients need to be utilized concurrently. Options are often tailored depending on where in the treatment process. We have many brightening options in our product line that can be customized for a specific patient or our HDS Brightening Complex Cream which contains all the listed ingredients in a shelf stable container. Procedures that are often recommended include chemical peels and laser treatments.

While this was a brief overview of melasma and some treatment options, for a more in-depth discussion, schedule an appointment with either Dr. Hamilton or me to get a customized routine to reverse and prevent. Allene, our esthetician, also offers the Brightening Peel. The fall/winter months are the perfect time to reduce the damage caused by all the summer sun.

Madison Hamilton, MMS, PA-C

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