1. MELASMA

2. What is melasma?
Melasma consists of brown spots/patches on both sides of the face, especially on the cheeks, upper lips, nose and chin. The distribution is usually symmetrical.

3. What causes melasma? 1. Hormone: Women of child-bearing age are prone.
2. Sunlight
3. Certain cosmetics containing fragrances
4. Deficiency of iron and folic acid

4. What are the types of melasma? MILD

5. Moderate

6. Severe

7. What are the types of melasma?
MILD
Moderate
Severe
The early phase in which pigmentation is located in outer layer of skin and is easily treated by
creams
The persistent pigmentation ,going into the inner layers and hence needs to be
Treated by topical creams
4-6 chemical peels.
1 session of laser
This ia difficult phase as the pigment has reached inner layers
Treatment approach is
4-6 chemical peels,
2-3 sessions of laser.

8. Is melasma recurrent. And why
Is melasma recurrent? And why? Yes, melasma can be very recurrent Because of stress, hormonal changes, sun exposure .

9. How to prevent melasma? 1. Maintenance treatment for several months
2. Life style alterations to avoid sun light.
3. Proper balanced diet
4.Avoiding Stress
5. Avoiding harmful cosmetics and facials
Unless patient understands these, and continues maintenance treatment recurrence is definite. And with each recurrence, pigmentation penetrates deeper, and becomes more and more difficult to treat

10. How to use sunscreens 1.Use sunscreens regularly, daily
2.Avoid sun exposure as far as possible.
3. Sun screen creams have to be applied daily, even if you are not planning to go out!!
4.Apply sunscreens two three times a day
5.Apply them half hour before leaving home

11. What are the creams used for melasma?
1. Skin lightening creams
2. Mild peeling agents
3. Use of mild steroid creams
4. The above drugs may be used combination-called Kligman’s formula.
The treatment usually takes several weeks.

12. What is the advanced treatment for melasma?
In longstanding cases, pigmentation may have penetrated deep in to the skin and in such cases response by above methods is inadequate. These cases need advanced treatment:
a) Chemical peeling by alpha hydroxyl acids (Glycolic acid-obtained from sugarcane)
b) Microdermabrasion- which involves use of aluminum oxide crystals under suction to remove superficial layers of skin
c) Fractional laser treatment

13. What is chemical peeling and how does it work?
A chemical solution is applied to the skin which causes it to separate, peel off, and allows new skin to regenerate.
The new skin is smoother and brighter and more even in color.

14. The type of chemical peel depends on the skin type of skin of patient

15. What is the use of lasers?
Fractional laser treatment is a new , safe, minimally invasive treatment
It works by targeting both the epidermal (superficial)and dermal (deeper)layers of the skin.
This laser causes a reaction that leads to collagen remodelling and new collagen formation.
The Fractional laser is designed to heal faster .
Another laser used in Q Nd yag laser to remove the accumulated pigment

16. FRACTIONAL LASER MACHINE

17. This is how laser is done
There may be only a slight redness for one day & the patient can go to work the very same day. Treatment is quick- only 15 minutes

18. Q Nd Yag laser is a specific laser for removing pigments

19. Before
After

20. Before
After

21. Before
After

22. Before
After

23. Before
After 2 sessions

24. Final message: prevention is as important as treatment
Treatment by creams, chemical peels and lasers Is effective in treating most cases of melasma
Prevention by using . Maintenance treatment , Life style alterations to avoid sun light, Proper balanced diet ,Avoiding Stress , Avoiding harmful cosmetics and facials is very important
Contact your dermatologist for more information