The Treatment of Facial Hyperpigmentation

Melasma , an acquired disorder of pigmentation due to hyperactivity of melanocytes ( the cells that produce melanin) caused by ultraviolet light stimulation and Post Inflammatory Hyperpigmentation ( caused by an over reaction to skin trauma ) are common problems of excessive pigmentation of the facial skin.

Though the problem is common and multiple treatments available, the consensus is that there is a need for a combination of treatment methods, with an initial intense treatment  period followed up by long-term maintenance treatment.

PHOTOPROTECTION  is the cornerstone of all treatments, to protect the skin from the effects of ultraviolet light ( UVB and UVA) and visible light, all of which stimulate melanocytes and in some instances overstimulate them. Broad spectrum skin protection against UVA ( 315 – 400nm ) and UVB (290 – 315 nm ) is critical. In addition, adequate clothing and hats add to the protection.

TOPICAL THERAPIES

Hydroquinone (HQ)  is a widely used topical depigmenting agent ( acting by reducing the amount of melanin produced ) and  works best when combined with a Retinoid  (which inhibits melanin transfer into epidermal cells and increases pigment removal by increasing the turn over  of pigment containing epidermal cells ) and a Corticosteroid.

The combination treatment is initially for daily use for up to 3 months, followed by a long-term maintenance therapy.

 

The Nd: YAG LASER

This laser has a longer wavelength ( 1064nm) and penetrates deeper while sparing the surface epidermis, making it safe to treat darker skin types and  deep dermal pigmentation. The treatment is quick and well tolerated and with no”downtime”. It is repeated at for weekly intervals for at least 10 sessions of treatment.

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