Melasma

Melasma is the frustrating patches of facial hyperpigmentation often associated with hormones; this includes your natural, everyday hormones, those your body produces with pregnancy, and hormones taken for contraception. The excessive melanin pigment in these patches can reside in the top living layer of cells, called the epidermis. This is also where pigment is when you get a tan. The body sheds this pigment regularly. The bad news is that melasma pigment can also reside in the deeper layer, called the dermis. This layer does not normally hold melanin pigment, and so is one of the reasons melasma is so hard to treat.

The cause for this excess pigment production is difficult to control, compounding the challenge of treating melasma. Some aspect of it is driven by the immune system. Short treatments of strong prescription cortisone creams have been used to treat it with moderate success. However, melasma tends to recur, and topical cortisone treatment has skin thinning (and other) undesirable side effects, and thus is not a good long term solution.

For all of these reasons, the treatment of melasma is tricky, yet significant improvement is possible. Treatment needs to be both consistent and very intensive, because the pigment production and deposition of melasma is tenacious. Your treatment needs to be equally tenacious. When I create a skin care routine to treat melasma, I cover all of the bases, including:

  1. First and foremost, sun protection, which needs to be absolute and used without exception, because one “indiscretion” in the sun will set you back after you have worked so hard to lighten the patches and even the color in your complexion. Sun protection needs to be broad spectrum and used 365 days a year. I trust only the mineral zinc oxide products for this job.
  2. Skin lighteners that reduce pigment production such as retinoids (retinol and prescription tretinoin), hydroquinone (2% available without prescription and 4% or higher with prescription), botanical lighteners like kojic acid, and vitamin C are all good options. Dead cells carry pigment upwards, accentuating the uneven skin color.
  3. Exfoliators to reduce pigment carried in the dead cell layer and enhance penetration of the lightening products. I use glycolic acid for this job. Rough scrubs and sponges can be used too.

This is a very intensive treatment and sensitive skin may become irritated – which can lead to inflammation and uneven pigment production! It may be good to enlist the help of a dermatologist to treat melasma in order to get prescription-strength products. Many over-the-counter professional products, such as the ones I have here, are highly effective and yet need to be used with care. At any sign of skin irritation or inflammation, a rest needs to be taken and then treatment resumed slowly. Options are based on what you know about your skin and your skin type.

I created the Ultimate Pigment and Sun Damage Repair Kit to incllude the best non-prescription products to fight hyperpigmentation, at the right concentrations to improve the pigment problem without irritating skin. The kit builds a complete skin care routine with compatible products that enhance ingredient penetration and sooth potential irritation so your skin can heal and improve simultaneously. 

If you want to build your own skin care routine, here is how I often treat my patients:

  1. Cleanse with a Clarisonic Brush (to help products penetrate better) and a gentle cleanser or a glycolic acid cleanser. A toner will help remove any residual dirt and skin oil to enhance penetration of products as well.
  2. Correct with Pigment Fading Pads followed by either Vitamin C or Glycolic Acid. At night, use a retinoid such as a professional retinol product. Because inflammation may drive melasma, I add green tea as an ingredient to calm inflammation naturally and safely.
  3. Hydrate to balance skin moisture with your favorite skin cream or lotion.
  4. Protect in the day from sun up to dusk with a good application of broad spectrum zinc oxide sunscreen. If makeup is worn, use mineral makeup to enhance sun protection.

References:

Shankar Krupa, et. al., Evidence-Based Treatment for Melasma: Expert Opinion and a Review, Dermatol Ther, 2014 Ded; 4(2): 165-186 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257945/

Melasma, American Academy of Dermatology, 2018 https://www.aad.org/public/diseases/color-problems/melasma

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  1. Dr. Bailey's Ultimate Pigment and Sun Damage Repair Kit

    Ultimate Pigment and Sun Damage Repair Kit

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    $327.00
  2. Dr. Bailey's Retinol Intensive Anti-Wrinkle Night Cream™

    Retinol Intensive Anti-Wrinkle Night Cream™

    Retinol is one of the best non-prescription skin care ingredients you can use to reverse the signs of skin aging. Every serious anti-aging skin care routine should include a retinoid product to improve your skin complexion quickly.

    $83.00
  3. Dr. Bailey's Retinol Ultra-Intensive Anti-Wrinkle Night Cream™

    Retinol Ultra-Intensive Anti-Wrinkle Night Cream™

    Ultra-high concentration retinol is one of the best non-prescription skin care ingredients to fight skin aging. A serious anti-aging skin care routine should include a retinoid product, and all-trans- retinol is the best non-prescription retinoid for the job.

    $94.50
  4. Ultimate Acne Solutions Skin Care Kit, Extra Strength™  1011

    Ultimate Acne Solutions Skin Care Kit, Extra Strength™

    Tolerant skin benefits from the high concentration of acne medicine in the Ultimate Acne Solutions Skin Care Kit, Extra Strength.

    $65.00
  5. Ultimate Acne Solutions Skin Care Kit™  1010

    Ultimate Acne Solutions Skin Care Kit™

    Most regular acne products are irritating to sensitive skin, but this acne treatment kit delivers the best acne medications at levels that are appropriate for sensitive skin.

    $56.00
  6. Sheer Strength Pure Physical Tinted Matte Sunscreen, SPF 50™  1217

    Sheer Strength Pure Physical Tinted Matte Sunscreen, SPF 50™

    Oil-free and oil control ultra-light and tinted matte technology in a hypoallergenic sunscreen – it’s the holy grail for oily and sensitive skin AND it’s elegant for all skin types too! Contains iron oxide too making it the best sunscreen for melasma. 

    $47.00
  7. Dr. Bailey Sheer Strength Pure Physical Invisible Sunscreen, SPF 50™ Broad Spectrum Protection

    Sheer Strength Pure Physical Invisible Sunscreen, SPF 50™ Broad Spectrum Protection

    Enjoy an oil free, non-whitening and “light as air” feel on your skin. Pure mineral zinc-oxide protection that’s perfect for even the most sensitive skin.

    $47.00
  8. Sheer Strength Pure Physical Spray Sunscreen SPF 50+™  1207

    Sheer Strength Pure Physical Spray Sunscreen SPF 50+™

    At last, an ultra-light sunscreen spray that’s pure mineral protection with micro (not nano) zinc oxide for the best anti-aging broad spectrum protection. 

    $44.00
  9. Dr. Bailey's Daily Foaming Facial Cleanser

    Daily Foaming Facial Cleanser

    Non-drying, soap-free and pH balanced foaming skin cleansing for thorough removal of excess oil, dirt, debris and product residue. Gentle enough for all but the most intolerant and sensitive complexions.

    $37.00
  10. Dr. Bailey's Extremely Gentle Foaming Facial Cleanser

    Extremely Gentle Foaming Facial Cleanser

    Foaming cleanser for complete skin cleansing without drying. Ideal for sensitive skin or skin made sensitive by professional skin care routines (such as glycolic acid, retinol or acne products) or facial skin conditions such as rosacea or seborrhea. The Gentle Foaming Cleanser is an ideal cleanser to alternate with Calming Zinc or your acne cleanser.

    $25.00
  11. Glycolic Acid Face and Body Wash  1291

    Glycolic Acid Face and Body Wash

    This rich soap-free cleanser brightens your complexion and leaves your skin silky smooth and ready for your treating and correcting products. Ideal for all skin types including oily skin because it gently but thoroughly removes product, oil, dirt and debris from the skin surface.

    $34.00
  12. Dr. Bailey's Triple-Action Exfoliating Cleanser

    Triple-Action Exfoliating Cleanser

    Eco-friendly beads combine with AHA and BHA to instantly brighten your complexion. Loosen dull dead cells and uneven pigmentation. Renew skin luster to a more youthful glow and instantly reduce the appearance of fine lines and wrinkles.

    $46.00
  13. Dr. Bailey's Bamboo and Clay Thermal Exfoliating Facial Scrub

    Bamboo and Clay Thermal Exfoliating Facial Scrub

    Get smoother, softer cleaner looking skin with a more luminous appearance with this magic combination of physical exfoliation and thermal clay deep pore cleansing.

    $52.00
  14. Glycolic Acid Anti-Wrinkle Face Cream  1254

    Glycolic Acid Anti-Wrinkle Face Cream

    The perfect AHA face cream for normal and combination skin. Available in 10%, 15% and 20% strength for all skin types

    $31.00
  15. Dr. Bailey's Foaming Acne Treatment Cleanser™

    Foaming Acne Treatment Cleanser™

    Our Dr. Bailey Foaming Acne Treatment Cleanser, formulated for sensitive skin types. This 2% Glycolic Acid/2% Salicylic Acid foaming cleanser is strong enough to remove oil and debris from clogged pores while remaining gentle enough for most sensitive skin.

    $22.00
  16. Dr. Bailey's Foaming Acne Treatment Cleanser, Extra Strength™

    Foaming Acne Treatment Cleanser, Extra Strength™

    This extremely strong 10% Glycolic Acid/2% Salicylic Acid foaming cleanser is the strongest acne cleanser I recommend. Regular use dissolves oil and black heads. It's ideal for tolerant skin.

    $26.00
  17. Salicylic and Glycolic Acid Acne Treatment Pads™  1035

    Salicylic and Glycolic Acid Acne Treatment Pads™

    2% Glycolic Acid and 2% Salicylic Acid acne treatment medicines are strong enough to treat stubborn acne but gentle on sensitive skin.

    $20.50
  18. Salicylic and Glycolic Acid Acne Treatment Pads, Extra Strength™  1036

    Salicylic and Glycolic Acid Acne Treatment Pads, Extra Strength™

    Tolerant skin benefits from 10% glycolic acid, which I think is the ideal concentration to loosen black heads. These medicated pads perform this feat while lifting oil and debris from the skin.

    $26.00
  19. Facial Glycolic Acid Kit for All Complexion Types

    Facial Glycolic Acid Kit for All Complexion Types

    Professional glycolic acid skin care products are among the best, non-prescription anti-wrinkle face creams that also fight sun spots. Glycolic acid rejuvenates and reverses so many of the signs of skin aging including: dull skin, fine lines and wrinkles, crepey skin, sun spots, and crusty age spots.

    $72.00
  20. Glytone Facial Cream #2  1028

    Glytone Facial Cream #2

    An extremely hydrating glycolic acid cream. It's a perfect starting point for beginning AHA therapy for dry skin types. 

    $50.00
  21. Glytone Exfoliating Lotion #2

    Glytone Exfoliating Lotion #2

    AHA therapy with a light water base for oily skin. Perfect for acne and anti-aging skin care for people with oily or normal skin.I have patients use it to improve acne and rejuvenate skin.

    $43.00
  22. Glytone Mild Gel Wash  1025

    Glytone Mild Gel Wash

    This is an excellent exfoliating foaming cleanser that preps the skin for glycolic acid creams and lotions. It's an excellent cleanser for acne treatment or to exfoliate as part of an anti aging skin care regimen.

    $31.00
  23. SunSavvy Kit, Daily Wear Protection   1013

    SunSavvy Kit, Daily Wear Protection

    The best dermatologist recommended mineral sunscreen products for everyday protection. This kit includes Citrix Sunscreen SPF 40 for the face, ears, and neck, along with Solbar Zinc Sunscreen SPF 38 for the chest, hands, and other areas that need sun protection.

    $41.00
  24. SunSavvy Kit, Ultimate Protection  1015

    SunSavvy Kit, Ultimate Protection

    The Ultimate Sun Protection Kit provides everything you'll need to protect your skin from the sun's harmful rays.This kit includes Sun Guard Laundry Treatment, UV Ray Detecto Ring, Vanicream Lip Protectant, Solbar Zinc SPF 38 Sunscreen and Citrix Sunscreen SPF 40 and a mesh travel bag for your products.

    $57.50
  25. Dr. Bailey's Citrix Sunscreen SPF 40

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    $35.00
  26. Glycolix Elite SPF 30 Sunscreen  1016

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    This is the ultimate in 'nonchemical', mineral, physical sun protection. It is perfect for people with extremely sensitive skin.

    $36.00
  27. Solbar Zinc SPF 38 Sunscreen

    Solbar Zinc SPF 38 Sunscreen

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    $13.00
  28. Suntegrity 5-in-1 BB Cream SPF 30 Tinted Moisturizing Facial Sunscreen  1208

    Suntegrity 5-in-1 BB Cream SPF 30 Tinted Moisturizing Facial Sunscreen

    This luscious and all natural face cream is my absolute new favorite face sunscreen! Natural, broad-spectrum mineral zinc oxide protection that feels and looks so good on your skin that you'll want to wear it 24/7.

    $45.00
  29. Suntegrity Natural Mineral Sunscreen Broad Spectrum SPF 30  1127

    Suntegrity Natural Mineral Sunscreen Broad Spectrum SPF 30

    Non-greasy natural non-nano zinc oxide mineral sunscreen for every day sun protection. This is a lovely natural mineral sunscreen made with organic ingredients - and it's not just for babies!

    $24.00
  30. EltaMD UV Clear SPF 46 Sunscreen

    EltaMD UV Clear SPF 46 Sunscreen

    Completely oil free and ultra light feel on the skin make this sunscreen a marvel. Perfect for oily to normal and acne prone skin. Comes with either a clear or tinted option to help soften complexion flaws for all skin types.

    $32.50
  31. EltaMD UV Daily SPF 40

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    Broad spectrum UVA and UVB protection in a lovely moisturizing lotion that's sheer and elegant of the skin. Perfect for normal to dry skin with it's hyaluronic acid and just a little light oil to moisturize your skin without leaving a heavy feel.

    $26.50
  32. Raw Elements Eco Stick SPF 30 Broad Spectrum Sunscreen  1078

    Raw Elements Eco Stick SPF 30 Broad Spectrum Sunscreen

    At last, the best mineral zinc oxide sunscreen product proven not to run into and sting your eyes - even when you're wet! Reef safe too.

    $16.00
  33. Clarisonic Brush Replacement Heads  1219

    Clarisonic Brush Replacement Heads

    Get the most out of your Clarisonic Cleansing System by keeping your Clarisonic Brushes in top shape.  Clarisonic recommends that you replace your brush head every 3 months to get the best results from your beloved Clarisonic Skin Cleansing System. Pick the right brush for your skin type to fully customize how the system works for you.

    $25.00

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