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Mastering the Treatment of Melasma

By: Raffy Karamanoukian, MD, and Hratch Karamanoukian, MD
Posted: February 28, 2012, from the March 2012 issue of Skin Inc. magazine.
Because melasma is a chronic condition with high rates of recurrence, clients who are predisposed to developing melasma may find current treatment modalities needlessly frustrating and difficult.

Because melasma is a chronic condition with high rates of recurrence, clients who are predisposed to developing melasma may find current treatment modalities needlessly frustrating and difficult.

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4. Chemical or mechanical exfoliation. This allows for more rapid exfoliation of melanin contained within the skin. The limitations of treatment include the depth of treatment. Clearly, microdermabrasion does not penetrate deep enough to affect deeper melanin deposits, while the efficacy of chemical peels is directly related to concentration and pKa of the medical acid.

Because melasma is a chronic condition with high rates of recurrence, clients who are predisposed to developing melasma may find current treatment modalities needlessly frustrating and difficult. Physicians and skin care professionals can facilitate the treatment process by utilizing the following core principals of melasma management.

Education

Melasma treatment begins with proper education. If clients do not understand the basic reasons for the development of melasma, they cannot possibly sustain a long-term commitment to melasma treatment.

There are three basic reasons why melasma develops in the first place—genetic factors, hormones and UV exposure. Take the time to explain these issues and address why they are relevant to your particular client.

Genetic factors. Melasma has a genetic component that is not well understood. Currently, it is believed that genetic influences make some individuals more susceptible to UV exposure and hormonal influences.1 If clients have a personal or family history of melasma, they are more likely to develop the condition in their adult life. It is imperative that susceptible individuals employ multimodality therapy, as described in the “Understanding melasma” section of this article, and commit themselves to long-term treatment for their condition.

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