melasma, chloasma, pigment be gone!!

I have suffered from odd spots of facial pigmentation since puberty, wise and knowing doctors would call this hormonal. If I picked a pimple the resulting scab would leave a dark mark which would eventually fade over time. During each of my three pregnancies I suffered from Chloasma (mask of pregnancy), this would fade a little between pregnancies but came back worse each time. After my last pregnancy it didn't go away. Having a rather mixed heritage my skin is a dark olive colour but the blotches are three to four times darker than my skin colour. The blotches are located on my forehead, from the middle to my hair line, on my cheeks from mid cheek running down to and on my neck and on my chin across the bottom.

I visited  a dermatologist who aided with a woods lamp diagnosed me with Melasma, he said I actually had two types of Melasma dermal and epidermal. The outlook was not good, dermal melasma is very deeply ingrained in the skin and is very hard to treat, epidermal is in the more upper layers of skin and can react better to topical type treatment. The next negative being I have dark skin, meaning if I start removing melanin (the chemical which makes skin colour) from one area I may not be able to match it with the other areas. Either way it was not going to be a quick fix, treatment would be long and expensive with no guarantee of success.

This was several years ago, I have learnt that the sun plays a major role in darkening Melasma, so I always wear sunscreen. I even blend my own mineral make up with added zinc for extra protection and better coverage. I have seen some fading but not much so I have decided to finally do something about it.

The Dr has prescribed for me some Retin A cream, which I use at night, (sparingly). This thins my skin allowing better absorption of the other treatments, plus helps to turn over dead skin, (peeling) which is also beneficial.
The next prescription was for a specially compounded mix of Hydroqinone 4% and Kojic acid cream, both of these substances, stop the skin from making more melanin and in effect bleach the area to which they are applied. I use this during the day under my sunscreen and makeup, careful not to use much as it is quite oily, and making sure I only apply it to the problem areas. I saw some improvement using this regime religiously day and night for three months but very little, so I took it up a notch.

Visiting a cosmetic beautician she suggested ipl (intense pulsed light) treatments for my entire face. This was very expensive and also slow going, as care was needed since the light reacts to dark melanin and my skin is also quite dark. After treatment, where my face is zapped about 20 to 30 times with what feels like a hot elastic band, my face feels very warm and goes quite red, the day after treatment I develop brown scabs, these gradually, disappear or flake away after several days.

It is not a dramatic difference after the first or even second treatment but with each treatment the beautician gingerly sets the machine a little higher. After my third treatment my entire forehead scabbed in the exact pattern of my melasma and after several days it flaked away resulting in clear fresh skin. I was so excited but by the end of the month as my next appointment loomed it had all reappeared just as dark as before. I under went a final ipl session before my budget finally gave in. So ipl is , plausible but way to expensive.

My beautician then suggested skin peels using Kojic acid in the hope that we could remove some of the discolouration this way. After revisiting the dermatologist he suggested I try this (carefully) but to still continue to use my retin a and bleaching cream for added results, as I had stopped using these for ipl. My first peel was nothing to rave about, felt like ants biting my face for the first 5 Minuit's then 5 Minuit's later it was cleaned away, over the next week my skin became quite flaky and peeled like sunburn and tho it felt wonderful my face still looked the same. The next peel was done a month later, and it felt hot, hot, hot my eyes actually watered, when it was being removed my skin was so tender it felt like it was being stripped away. The beautician felt this reaction had something to do with the retin a cream, and watched me leave very nervously.

For the next two days I didn't leave the house as I was one big scab, I kept a cooling moisturizing gel over my face only washing with water. On the third day it became quite itchy and started to flake even with the gel. After a week all of the scabs had washed away leaving my skin quite pink in areas, but feeling soft like a babies bottom. Most of my melasma was still present but it had faded and some areas are patchier. After the pinkness had subsided I started back with my retin a and hydroquinone. So far so good!

My most recent acquisition is a Viss personal IPL machine, this machine has separate attachments (globes) for hair removal and skin rejuvenation. I have used it several times (on very low setting) on my face using the skin rejuvenation globe, I shall continue in this manner 3 or 4 times a week for a month and see if it makes a difference to my melsama at all. I will continue to use my retin a and hydroquinone creams as well as taking some additional dietary suppliments I have heard help get rid of pigmentation. These are MSM (methylsulfonyl methane) aceytl lcarnitine, vitamen c, zinc, folic acid and coq10.

Watch this space for up dates on my treatment and if you would like to know anything more about any of the treatments mentioned please don't be shy.