Face pigmentation removal involves several types of topical treatments to whiten the skin and remove pigment. With the help of some other treatments, the surface layer of the skin is removed, and with it the excess pigment.
Hyperpigmentation and melasma
Hyperpigmentation on the face is mostly a consequence of the so-called melasma, which usually occurs on the face, namely on the cheeks, chin, upper lip, nose ridge and forehead. It is caused by increased production of the melanin pigment in the skin.
The exact cause of melasma is not known, but it is known that several factors affect the occurrence of melasma. Hormones and exposure to the sun (or indoor tanning) are the most important factors, while genetic predisposition is also significant. Changes in hormonal status can trigger the disease and contribute to the appearance of dark spots on the face.
Melasma mostly affects women, while only 10 percent of patients are from the male population.
Ultraviolet radiation from the sun, indoor tanning, and even stronger interior lighting stimulate skin cells to produce pigment. This is especially pronounced in people with a darker complexion, in whom the cells in the skin responsible for the production of melanin are more active. Sun exposure is the most important cause of the reappearance of dark spots after successful treatment of melasma.
The appearance of melasma can also be affected by pregnancy, and it can be caused by contraceptive pills.
The mechanism of melasma occurrence is similar to that of age spots and blemishes, but melasma often covers a larger area of the skin.
Melasma is not a sign of disease or dysfunction of any of the organs and does not affect a person’s health. However, it is an aesthetic problem. Although melasma is not painful and does not pose a health risk, it can be a source of significant emotional stress and therefore adequate diagnosis and therapy are important.
Diagnosis of melasma
In most cases, only a visual examination is sufficient as the clinical picture is very characteristic, and a dermatological examination using a Wood’s lamp helps to assess the depth and extent of hyperpigmentation.
Very rarely, a skin biopsy with pathohistological analysis is necessary to establish whether the patient suffers from melasma or another cause of hyperpigmentation.
There are three types of melasma:
– Epidermal melasma – light brown colour, the pigment is in the upper surface layers of the skin
– Dermal melasma – ashy blue-gray colour, the pigment is in the deeper, third layer of the skin
– Mixed melasma – dark brown colour, with pigment in both upper and deeper layers of the skin.
When diagnosing melasma, it is important to find the cause of hyperpigmentation. It should be noted that without treating the cause, the treatment will usually be less effective, with an increased risk of recurrence of hyperpigmentation.
Face pigmentation removal
Strict sun protection is necessary in the treatment of melasma, so the use of protection creams containing physical filters such as zinc oxide and titanium dioxide is recommended. Sunscreens must contain UVA and UVB protection, and the SPF must be at least 30.
Topical use of hydroquinone, vitamin C, azelaic acid, kojic acid is most common for melasma. The treatment must last at least three months and can be effective only in very mild forms of melasma.
Regular hygiene and facial cleansing are very important as environmental pollution can contribute to the appearance of melasma. Impurities in the air can bind to the skin, damaging its protective layer, which increases the negative effects of the sun.
Chemical peels and PRP treatments often produce good results. However, melasma is a chronic skin condition, and some types are difficult to remove and tend to recur.
If the response to local therapy is poor, laser melasma removal is the only effective method.
In Dermatim clinic, the face pigmentation removal is performed using a topical treatment that involves the use of appropriate creams depending on the appearance and type of changes, in combination with chemical peels and laser treatments, whereby the laser emits a wavelength adapted to the skin pigmentation removal.
Laser face pigmentation removal
In our clinic, melasma is removed using the Q-switch Candela laser, model Alex TriVantage, which is extremely successful in melasma removal all over the world.
In addition, we use the VBeam laser which together with a cream combining hydroquinone, retinoids and corticosteroids achieves excellent results in the treatment of melasma.
During the treatment, the laser beam is absorbed into the pigment in the skin, after which the pigment is broken down. After the treatment, redness may appear on the treated areas, which usually disappears in one to two days.
The surface of the skin is dry and flakes easily following the treatment. It is necessary to use creams that promote skin re-epithelisation for ten days after the laser treatment. The use of SPF 50+ creams for sun protection is mandatory and the use of skin whitening creams is recommended in order to achieve the maximum effects of melasma removal treatment.
It usually takes two to four treatments to remove pigmentation from the face, depending on whether the pigmentation is superficial, deep or mixed.
Some types of melasma tend to recur, but after laser treatment, the likelihood of recurrence decreases. In this case, the patient is advised to repeat the treatment once a year in order to prevent the recurrence of melasma.
References:
– The vascular characteristics of melasma, En HyungKimYou ChanKimEun-SoLeeHee YoungKang
– Long-lasting effect of vascular targeted therapy of melasma, Thierry Passeron
– Laser Eradication of Pigmented Lesions: A Review
– Laser eradication of pigmented lesions and tattoos, Suzanne LinsmeierKilmer MD
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