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Melasma is a facial skin condition that presents with blotchy areas of hyperpigmentation distributed primarily over the forehead, cheeks, upper lip and less commonly the chest and neck area. The exact cause of melasma is unknown however it is believed that the pigment producing cells known as melanocytes, become over active producing more melanin in selective locations. There are variations in human pigmentation with individuals with darker skin types producing more melanin, which is controlled by the rate-limiting enzyme tyrosinase. Individuals with darker skin tones are at greater risk for melasma than fair skinned individuals. A wood’s light used to be utilized in the past to make a diagnosis of melasma, but currently it is a common clinical occurrence. Any type of increase in estrogen or progesterone intake or production are also associated with this skin condition. Therefore, birth control pills, hormone replacement, pregnancy, and hormone therapy can all trigger melasma. Stress and thyroid disease have also been postulated to be causes of melasma.

Skin Irritation or contact dermatitis reactions in the face can also cause hyperpigmentation which is treated in the same manner as melasma. Other recent causes of melasma are improper laser treatments in patients with darker skin types or those prone to melamsa. Melasma is always worsened through sun exposure. Visible light or Sun light exposure, as a result of the damaging UVA and UVB rays, cause the appearance of melasma. These pigmentary changes are one of the most common reasons that patients consult with Dr. Michele Green for skin lightening in her NYC dermatology office. The dark facial brown patches of Melasma are also called chloasma, or the “mask of pregnancy,” when the facial discoloration occurs in pregnant women. The condition is much more common in women than men, though men have this condition as well. Dr. Pandya of the AAD also describes the history and treatment of melasma. According to the American Academy of Dermatology, 90 percent of people who develop melasma are women.

Cosmelan: 10 weeks before & after

With the rise of melasma, Skin lightening consultations are on the increase with the greater incidence of pigmentation, dark spots, and melasma. During the initial consultation with Dr. Green, the various treatment options for melasma and skin lightening are discussed. It is very important to first review which topical treatments or combination creams wbeen used in the past to treat these brown patches. Typically, patients with darker skin types who have had IPL, Picosure, or Fraxel laser to treat this hyperpigmentation will be much more difficult to treat since the pigmentation will have developed deeper. In these cases, you will be treating both melasma and the side effect of the post-inflammatory pigmentation on the skin which can be even more difficult to treat. First, proper skin care, over-the-counter products, and sunscreen will need to be reviewed. Many patients benefit from topical Vitamin C combined with Retinoids, Retin-A, and Hydroquinones. Dr. Green has a special line of MGSKINLABS, Inc. products designed just for skin lightening, melasma and these pigmentary problems. It is always important during this treatment process to use the correct broad-spectrum sunscreen, which will protect you against both UVA and UVB sun damage. Superficial melasma can benefit from microdermabrasion or chemical peels with glycolic acid or trichloroacetic acid. It generally takes a series of chemical peel to renew the skin cells and lighten the skin. Oral Tranexamic acid has also been described to have some moderate success in treating facial melasma.

The treatment of Melasma and hyperpigmentation have historically been some of the toughest skin conditions to deal with because the facial discoloration lies so deep within the skin’s surface. Dr. Green is a specialist in treating melamsa with the Cosmelan peel. The Cosmelan® Peel is a unique, multi-ingredient treatment which combines high strength Tretinoin and Hydoquinones and treats these areas of skin discoloration, dark patches and hyperpigmentation. Through the use of this “leave-on” peel which will be customized based on your skin type and pigmentation for 4 to 10 hours, your melasma will be successfully treated.

CB cosmelan 51 before after 11 month LEFT MGwatermark

View additional Cosmelan before and after photos

The Cosmelan® chemical peel decreases the skin’s natural melanin production by inhibiting certain enzymes, providing an even complexion. Cosmelan treatment involves a very versatile, dynamic process which is easily adapted to the needs of each individual patient. The Cosmelan® peel is a professional-grade cream that is applied by board certified dermatologist Dr. Michele S. Green in her practice on the Upper East Side. The mask is left in place for a number of hours (depending on the degree of pigmentation and skin type). The cream is easily removed at home by the patient several hours later. Cosmelan® will produce an initial “peeling” of the skin, which will leave the skin smooth and dramatically decrease the signs of facial pigmentation, lightening discolored areas. Cosmelan® is a simple and safe treatment with minimal down time. The patient returns three weeks later for a touch-up of Cosmelan® in order to treat any residual pigmentation.

A series of lotions including kojic acid, azelaic acid, and Vitamin K creams are used at home after the mask to maintain the effects of the procedure and keep the skin clear and pigment-free. Strict sun avoidance must be maintained throughout the procedure and afterwards in order to avoid side effects such as pigmentation recurrence. Avoid sun exposure for proper skin care, and use high SPF sun protection cream if you must go outside. If you’re ready to bring out the best in your skin, contact us online today or call 212-535-3088 to learn more about why Dr. Green is a trusted source for melasma treatment in New York City.

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