Determine the root cause by examining the client’s skin health history, observing pigmented lesions, determining when and what associative factors accompanied the onset of melasma,1 and performing proper imaging and biometric analysis.
If PIH is present, do not apply light, heat or peel modalities of treatment as the first course. Suppress any active inflammation first; then, it is safe to lighten skin with topicals, followed by light, heat or peel treatments.
Epidermal melasma, which is active, should not be treated with laser or IPL.
Dermal melasma is very difficult to treat. Customized formulations, which provide the depth of the bioavailability of active lightening agents, are critical to success.
Combination treatments are often extremely successful in treating melasma when performed in a specific sequence or concurrently, depending on specific conditions.
When treating any hyperpigmentation disorder with lasers, IPL or chemical peels, pre-treat for a minimum of two weeks with a potent skin-lightener to immobilize the melanocytes—often hydroquinone alone is not enough—followed by a post-treatment regimen of one month.
If you suspect PIH is occurring after a procedure or when a client presents for treatment, apply skin-lighteners with anti-inflammatories immediately. In general, clinical studies have indicated that once PIH persists on skin for 10 days to two weeks, it is very difficult to suppress.