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AAD Looks at Treatments for Conditions Targeting Those with Darker Skin Tones

Posted: September 30, 2009

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For this reason, Dr. Breadon advises patients with melasma to consider stopping oral contraceptives and hormone replacement therapy due to the large amount of estrogens in these medications. Regular sunscreen use is vital to protect the skin from further hyperpigmentation.

With melasma, the skin can be affected in three different ways: on the epidermis (superficial layer), in the dermis (deep layer) or a mixture of both the epidermis and dermis. Dermatologists use a light device known a the Woods lamp, which shows skin diseases as specific colors, to determine how deep melasma has penetrated the skin.

For superficial melasma, the triple cream combination of hydroquinone, retinoic acid and mild hydrocortisone with regular sunscreen use can be effective, with clearance occurring in about three months for most patients. Dr. Breadon noted that cases where melasma has penetrated the dermis are very difficult to treat and the combination triple cream medication will not be effective in these patients.

However, some patients may experience improvement with microdermabrasion, dermabrasion, chemical peels or lasers. In cases where both the epidermis and the dermis are involved, the triple cream medication may offer some improvement for some patients.

“Melasma is hard to define, as it can occur in women during or after pregnancy or in women who have never been pregnant or used oral contraceptives,” said Dr. Breadon. “While lasers can be effective, there are risks of further hyperpigmentation and results vary greatly from person to person. Dermatologists can help patients decide the best course of treatment, depending on the severity of the condition.”