Melasma and Hyperpigmentation Management

Most treatment failures arise from inadequate treatment follow-up and medical management. There is no one-and-done procedure or treatment.

Likewise, there is no one-size-fits-all approach for melasma. Melasma is more common in women, but can also affect men. Melasma can certainly be managed, but there is no surefire cure. Since melasma is caused by a combination of factors, it is important that your medical history be reviewed. You will be evaluated for severity, duration of melasma, triggers, risk factors, and previous treatment successes or failures.

A variety of therapies are available that inhibit your skin’s tendency to overproduce pigment, known as melanin, in areas such as your face. Prescription products can be used to inhibit your skin’s biosynthesis of melanin, to increase the turnover of “stained” skin cells with cleaner, newer ones, and to accelerate the removal of your dead skin cell layer.

Dr. Lum will help educate you about the risk factors and triggers for melasma. It is essential that you use a broadband sunscreen that protects against ultraviolet (UV), visible, and infrared light on a daily basis. Depending on your history and severity of melasma, there are first-line and second-line therapies that will be considered. An appropriate treatment plan will always include maintenance therapy to reduce the risk of recurrence.

First-line therapies may include prescription hydroquinone used once or twice daily, combined with non-hydroquinone agents such as retinoic acid. Examples of non-hydroquinone skin lighteners are azelaic acid, kojic acid, arbutin, vitamin C, niacinamide and cysteamine.

Second-line therapies include tranexamic acid and superficial chemical peels such as those containing glycolic acid, salicylic acid, and trichloroacetic acid (TCA). Cosmeceutical products often contain forms of some of these ingredients that can be applied topically as part of a daily skin routine.

Cosmelan MD is a first line treatment option for those with moderate to severe melasma. It is a powerful, physician-guided prescription system that regulates the overproduction of melanin in pigment producing cells (melanocytes) in your skin. It inhibits and controls the appearance of new dark spots.

Cosmelan® reduces the appearance of skin discolorations affected by genetics, hormonal imbalance, excessive sun exposure and other triggers in all skin types. External and internal factors cause hyperpigmentation.

After cleaning and degreasing your face, the doctor will apply Cosmelan 1 intensive face mask to your face to lighten the pigment, and suppress the overproduction of new pigment. This has to be applied in a very specific manner to achieve optimal and safe results. Depending on your skin type, this mask may be left on for up to 8 to 10 hours.

You will be given a Cosmelan home pack that includes the Cosmelan 2 depigmenting mask, melan recovery, and melan 130+ with a very high factor sun protection with UVB 130 and UVA 67 color with depigmenting ingredients that help regulate melanin synthesis.

At no additional cost to you, Dr. Lum will be available to guide you through this process with office visits, baseline and follow-up photographs that are standardized using an aesthetics photo system. Also included, is a one month spot-treatment follow-up, and even subsequent visits to monitor your progress, and recommend post-procedure melasma management.