The Skinny
Melasma can be a temporary or chronic skin condition (learn more in our complete guide to Melasma Concerns). Sun exposure to UVA and UVB rays, birth control pills, hormone replacement, thyroid disease, and pregnancy may cause temporary melasma. For men and women who have chronic brown patches from melasma, treatment may be desired. Chemical peels, laser skin resurfacing, skin-lightening topical medications, and microdermabrasion can all treat melasma.
The Specifics
Who may consider procedures to treat their melasma?
Quick recap: Melasma is the overproduction of melanin (skin pigment) by melanocytes (pigment producing cells) that reside in the upper most layer of skin (epidermis). Below the epidermis is the hair follicle and sweat gland containing dermis, and then at the very bottom the hypodermis which is composed of fat and connective tissue.Melasma is not entirely understood. There are correlations to genetics, sun exposure, hormonal changes, birth control use, and skin irritants. It is significantly more prevalent in women, darker skin individuals, and pregnant women.
Melasma is diagnosed by a dermalogist using a special light called a wood’s lamp. Melasma does not have to be treated and can naturally fade once underlying factors are removed. If an individual does wish to pursue treatment, however, there are a number of available modalities.
What can you expect from melasma treatment?
Melasma treatments vary in intensity. The type of treatment a healthcare provider uses will be dependent on the severity of your condition, skin type, and skin sensitivity.- Chemical Peels: These exfoliating treatments can penetrate through multiple layers of skin tissue depending on the intensity of the agent used.
- Laser Skin Resurfacing: Heat and light therapy melt your face off. That’s not entirely accurate. More like it dissolves damaged skin and encourages cellular repair.
- Microdermabrasion: Like a carpenter sanding wood, a provider will exfoliate skin with a special instrument.
- Topical Medication: These medications are usually employed as first line therapy and can lighten skin tone with regular use.
Chemical peels, laser skin resurfacing, and microdermabrasion are also good options that can provide additional rejuvenating benefits. Some patients also use topical azelaic acid and/or kojic acid with good results.
When should you consider a treatment for melasma?
Keep in mind that melasma can resolve on its own. If you are pregnant, melasma typically fades postpartum. Some individuals only experience melasma in the summer months when they develop a tan. Skin irritants and birth control can also be stopped to see if melasma fades.For those with a genetic component or those who cannot stop birth control or certain skincare products, professional treatments can help to manage symptoms. Most all treatments will require multiple sessions to gain initial results, followed by maintenance appointments. While there is definitely a commitment to treatment, the regular therapy can produce significant results.
Why should you consider treatment for melasma?
Again, the decision to treat melasma is entirely person dependent. For those who have determined their melasma is not correlated to a modifiable factor (like skincare or another temporary condition), treatment for melasma can be pursued.Chemical Peels for Melasma
Chemical peels are used to dissolve and exfoliate dead, damaged, and pigmented skin to rejuvenate the skin and promote healing.- Superficial Chemical Peels
- Overview: This peel stays at the top most skin layers.
- Cost: $3,000 - $6,000
- Recovery & Results: Slight redness and irritation for a day. The results are temporary.
- Glycolic Peel
- Overview: A peel utilizing glycolic acid as it’s base.
- Cost: $200 - $600
- Recovery & Results: Some mild irritation. The results are temporary.
- Salicylic Acid Peel
- Overview: A common peel that can vary in intensity depending on the concentrations of salicylic acid.
- Cost: $100 - $300
- Recovery & Results: Minor irritation for about two days. Multiple treatments and maintenance are required.
- Jessner’s Peel
- Overview: A combination treatment of salicylic acid, lactic acid, and resorcinol.
- Cost: $25 - $675
- Recovery & Results: Skin flaking may last up to one week. The results are temporary.
Laser Skin Resurfacing for Melasma
Lasers target old, damaged skin cells to promote new growth and healing. Since some laser thereapy can cause melasma to worsen, it's important to see a board certified laser specialist.- Non-Ablative Fractional Laser Skin Resurfacing
- Overview: Unlike it’s non-fractional counterpart, fractional laser therapy is targeted to specific areas.
- Cost: $1,000 - $1,150
- Recovery & Results: Skin will feel raw, red, and irritated for about two weeks. The results are temporary and require multiple treatments.
- IPL
- Overview: Intense pulsed light therapy uses light to target uneven pigment and blemishes in the skin
- Cost: $500 - $2,100
- Recovery & Results: Mild stinging and irritation for a few days. Multiple treatments for the best results.
Microdermabrasion for Melasma
Microdermabrasion is a gentle exfoliating procedure that remove the superficial layers of skin to expose newer, healthier skin and restore tone and texture.- Crystal Microdermabrasion
- Overview: A crystal-tipped instrument exfoliates the top layer of skin to promote rejuvenation.
- Cost: $75 - $300
- Recovery & Results: Some redness and irritation for a day or two. Multiple treatments for best results.
- Diamond Tip Microdermabrasion
- Overview: Like crystal microdermabrasion, a diamond-tipped is used to exfoliate the skin.
- Cost: $100 - $350
- Recovery & Results: Some irritation for a few days. Treatments every two to three weeks will create the best results.
Topical Medication for Melasma
If you are diagnosed via Wood’s light by a dermatologist, they will most likely recommend or prescribe one or both of these medications. They can be very irritating so their use should be carefully monitored.- Hydroquinone
- Overview: The first-line melasma medication that works to lighten skin tone.
- Cost: Dependent on insurance
- Recovery & Results: Slight redness and irritation at the site. Results dependent on consistent use.
- Tretinoin
- Overview: An adjunctive medication to hydroquinone that can also provide lightening effects.
- Cost: Dependent on insurance
- Recovery & Results: Can also cause irritation and redness. Requires regular use.
The Takeaway
Regular skincare is a staple of most men and women’s daily routine in the United States. Limiting excess sun exposure, broad spectrum sunscreen, wide brimmed hats, and protective clothing can stave off many skin problems. Melasma, however, can have numerous causes and, therefore, individuals may benefit from professional treatment.
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