Melasma also known as the pregnancy mask is classified as dark patches on the skin. A uniform brown color is usually seen over the cheeks, forehead, nose, or upper lip. It is most often symmetrical (matching on both sides of the face). In Mexicans and Asians it is hard to treat and makes it difficult for the patient and the doctor. Treatment results are very gradual and treatment modalities should be used very gently. Aggressive treatment could possibly make the condition worse.
Treatment would include the following: Topical de-pigmenting agents, such as Hydroquinone and Tretinoin, which is an acid that increases skin cell (keratinocyte) turnover. This treatment cannot be used during pregnancy. Chemical Peels work wonderfully. Especially the Vi Peel which is a repair peel and takes all the dead layers of skin off giving our patients a deep peel that will smooth the skin as well as diminishing melasma. Microdermabrasion would help slough off the dead layers and work especially well after a laser or peel. If the melasma is dermal, Fraxel laser has been shown in studies to provide improvement in many patients. IPL has also been effective.
