Melasma is characterized by homogenous areas of dark pigmentation that most commonly appear on areas of the face such as the forehead, upper lip, and cheeks.
Melasma can be triggered by hormonal changes of pregnancy, or from exogenous hormones such as birth control pills or hormone supplements.
Melasma can be worsened by certain topical treatments and laser treatments, so expertise is key in successful management.
Daily broad spectrum sun protection is essential to the treatment of melasma. Mineral sunscreens are best since even visible light can worsen melasma.
Topical brighteners can help to fade unwanted pigmentation, but must be carefully chosen so as not to trigger additional pigmentation caused by inflammation of the skin.
The most data-driven approach to treating melasma is with the new Clear+Brilliant Perméa laser. The 1927nm wavelength is very effective at targeting the darker areas of pigmentation without inflaming the skin. Dr. Sherber uses the opportunity immediately post-laser, when absorption of topical treatments is increased 17x, to apply a customized blend of brightening serums to each patient’s skin for added benefit.
Depending on the depth and severity of melasma, Dr. Sherber may pre-treat the skin for several weeks prior to laser treatment using a tailored regimen of topical treatments.
Dr. Sherber may recommend labs to check for hormonal irregularities ranging from estrogen hormones to thyroid imbalances.
If melasma is triggered by oral contraceptives, Dr. Sherber may recommend changes to your medication regimen.
Dr. Sherber does not recommend IPL in the treatment of melasma since for most skin types it can result in initial improvement and subsequent worsening of pigmentation.