Melasma

"Melasma is the term used to describe hyperpigmentation of the skin, which can manifest itself as brown-reddish patches.Melasma on the face - whether localized or extensive - is a frequent reason for consulting a dermatologist. Laser technology provides a low-pain treatment option here."

C. Bettina Rümmelein, M.D., Specialist in Dermatology & Venereology
C. Bettina Rümmelein, M.D., Specialist in Dermatology & Venereology
Symptoms

Melasma symptoms

Melasma, also known as chloasma, is a condition characterized by symmetrical, brown-reddish pigmented patches on the skin. These discolorations are typically well defined and can vary in intensity, from light, barely noticeable tones to darker, more pronounced shades.

The classic appearance of melasma significantly shapes the skin appearance and is mainly visible on the cheeks, forehead, upper lip or chin. In some cases, it may also affect other parts of the body that are regularly exposed to the sun, such as the neck and forearms. The localization and extent of melasma makes it clearly visible to the environment and can therefore be psychosocially stressful for those affected.

Although melasma has no disease value and does not cause physical discomfort such as pain or itching, it can be a significant cosmetic problem. It can affect the self-esteem and general well-being of those affected, especially since it can be difficult to treat in some cases and often recurs chronically.


Photos and videos

Causes

Melasma causes

Melasma occurs due to an overproduction of melanin, the natural pigment responsible for the coloration of our skin, hair and eyes, among other things. This phenomenon occurs when melanocytes, the special cells in our skin that produce melanin, are stimulated by certain factors. The two main triggers for this stimulation are UV light and hormones, especially the female hormones estrogen and progesterone.

The relationship between hormones and melasma explains why women are affected by this skin change much more frequently than men. Hormonal fluctuations, such as those that occur during menstruation, pregnancy or when taking hormonal contraceptives, can stimulate melanin production. It is worth noting that during pregnancy, a time of intense hormonal change, 50-70% of women can be affected by melasma, often referred to as 'pregnancy mask'.

UV exposure also plays a central role in the development of melasma. Sunlight stimulates melanin production, which means that hyperpigmentation is often more pronounced in summer than in winter. This also explains why melasma often appears in areas that are regularly exposed to the sun, such as the face.

There are also genetic factors that may play a role in the development of melasma. If close relatives have melasma, the risk of developing melasma yourself is increased. In addition, certain ethnic groups, especially those with darker skin, are more prone to this condition.

Treatment

Melasma treatment

You should come to the treatment without make-up so that laser treatment can begin immediately. The treatment itself takes about 20 minutes, during which the affected areas are gently treated with the laser. After the treatment, we will provide you with products that you can use to remove your make-up afterwards.

Several options are available for the treatment of melasma:

Depending on the diagnosis, local therapy with bleaching preparations or special laser therapies can be used for melasma treatment. However, often a combination of different methods provides the best results. With the combined methods, we can achieve an improvement in skin appearance of over 50% in 80% of patients, although this cannot be guaranteed in individual cases. The number of treatments required varies depending on the individual case.

Laser and light treatments

We have been working successfully for years with gentle laser toning, also known as the "Asian Way". This procedure can be carried out with our Spectra laser as well as with the Nd:YAG picolaser.

  • Q-switched Spectra Lasertoning
    • For darker skin types, a gentle laser procedure is chosen, which is applied repeatedly. Please count on 5-15 treatments.
  • Pico Laser Toning
    • This procedure uses the Nd:YAG wavelength, which penetrates particularly deep into the skin.

Both methods are suitable for all skin types and can be used all year round. In case of difficult response, we switch to the slightly invasive LaseMD in the course of treatment.

  • LaseMD
    • An innovative method of delivering tranexamic acid into the dermis using a thullium laser.

Cream treatment

The basis of any melasma therapy is consistent and double light protection. This involves the combination of chemical and physical photoprotective filters. In addition, a bleaching preparation is needed that aims to inhibit tyrosinase. Tyrosinase is an enzyme that plays a key role in melanin production and thus contributes to the development of melasma.

Please note that melasma can be resistant to treatments in rare cases. Therefore, we attach great importance to individual care and therapy adjustment. In such cases, patience and perseverance are of great importance. We will be happy to support you on your way to improving your skin appearance and effective melasma treatment.

 

Frequently asked questions

Melasma Frequently Asked Questions

What is the right melasma treatment for my skin type and condition?

Hautwerk first analyzes the possible provocation factors for your findings and in most cases we start with a treatment with Nano-Toning which is a painless treatment where a laser beam is wiped over the skin. The treatment lasts about 10 min. and is repeated every one to two weeks. The goal of the treatment is to "crack" the deep-lying pigment, making it available to natural phagocytosis. This treatment has no downtime. After the treatment, an anti-pigment sunscreen is applied immediately, make-up can be used additionally. After five treatments, the findings are re-evaluated with our photo system and the next course of action is decided with you.

What can I expect during a melasma treatment session?

Nano-Toning treatment for melasma is not painful. You will only feel a tingling sensation on the skin. In several lanes, the problem areas are treated five to six times overlapping.

Is there a downtime or recovery period with melasma treatments?

No. With Nano-Toning you have no downtime, with the other therapies such as Pico-Toning or LaseMD you must expect two to five days of downtime. However, makeup can be reapplied after one to two days here as well.

How long does it take for the results of melasma treatment to become visible?

Unfortunately, you have to be patient because the blasted color has to be removed from your skin. Therefore, the first control will take place after five weeks at the earliest.

Can melasma treatments be combined with other skin care procedures?

Not only can they be combined, they must be combined. At your first appointment at Hautwerk, you will receive a coordinated care concept which contains lightening active ingredients.

What kind of aftercare is required after melasma treatment?

The most important thing is consistent sun protection. There are specially developed aftercare products and serums for LaseMD treatment.

How can I prevent melasma from reappearing after treatment?

The most important preventive measure is the daily careful use of sunscreen with anti-pigment active ingredients.
Further information

Further information

Publications
Hyperpigmentation.
Rümmelein, B./Navarini, A. / Hautnah Dermatologie, Issue 05/19: 30-35
Publications
Melasma and the different treatment options.
Eichner, S./Rümmelein, B. / Aesthetic Dermatology skinMAG, Issue 01/18: 60-63
Article
Melasma Awareness
Dr. med. (I) Ikonija Koceva

Further information

Publications
Hyperpigmentation.
Rümmelein, B./Navarini, A. / Hautnah Dermatologie, Issue 05/19: 30-35
Publications
Melasma and the different treatment options.
Eichner, S./Rümmelein, B. / Aesthetic Dermatology skinMAG, Issue 01/18: 60-63
Article
Melasma Awareness
Dr. med. (I) Ikonija Koceva