Treating Melasma

Not long after giving birth to my third child, I began to notice changes in my skin. Not the good kind. My pores seemed to have grown twice as big as they used to be. I developed acne, mainly in the form of ugly blackheads, worse than I ever had as a teenager. My skin looked as tired as I felt, and nothing I did seem to make a difference.

While scrutinizing my face one day in the mirror, I noticed that it looked "dirty." But that wasn't possible since I had just washed my face. For several months I wondered what could be causing my face to look this way. I had never heard of melasma (also known as chloasma).

As I sat watching TV one afternoon, while my youngest was snoozing happily in his crib, I spotted a commercial where they were describing the same symptoms that I was experiencing on my face. Brown splotches spread over my forehead, cheeks, and chin. Granted, my case was mild compared to the woman on TV, but it was such a relief to finally have a name for my "dirty" skin condition. And there was a treatment, as the commercial went on to inform me.

I headed to my computer of course, to research melasma symptoms and treatments. In the course of my research, I came upon the very same treatment product I had seen on the TV commercial, called Tri Luma. My next step was to make an appointment with a dermatologist to further explore my options. Long story short, the dermatologist I visited was absolutely no help at all. His exact words to me were, "Stay out of the sun, maybe it will go away. And don't try any of those fade creams." Huh? That's it? Stay out of the sun. . . yeah, that was feasible with three kids, one who plays baseball year round!

If a more aggressive treatment for this condition is desired, finding a good aesthetician, preferably one who works in a doctor's office (such as a plastic surgeon's office) might be the way to go. That's who prescribed my Tri Luma, a wonderful aesthetician I found in a plastic surgeon's office who happened to be right next door to my son's ENT doctor.

Melasma can be caused by the use of oral or patch contraceptives, hormone replacement therapy medications, or quite often shows up in women who are pregnant or have recently given birth, thus the nickname "mask of pregnancy." The only symptom of melasma is the dark, brownish patches of discoloration on the skin that usually appear gradually.

Will melasma go away on its own if left untreated? Most of the research I've done on this condition points to no. If the melasma is caused by hormone treatments, either contraceptive or HTR, the blotches may fade once hormone treatments are stopped. If caused by pregnancy, they may eventually fade on their own, but ultimately the dark patches will probably need to be treated before fading altogether. Even then, a maintenance product is often needed to maintain a more even tone to the affected skin. And a good sunscreen, SPF 30+, is a must, especially if an over-the-counter fade cream of some kind is being used. I tried a few of these, and they did offer a small degree of fading, but I was looking for something stronger.

Typically in fade creams (topical depigmenting agents), the active ingredient used is hydroquinone, which inhibits the production of tyrosinase. the enzyme involved in melanin production. Over-the-counter fade creams usually contain a 2% solution of hydroquinone and prescription-strength products contain a 4% solution. That 2% difference can make a drastic difference.

Back to the product I saw on TV - Tri Luma. It is only available by prescription, it may have side effects for some users, and you absolutely must practice good sun protection when using this product. Besides 4% Hydroquinone, Tri Luma also contains a topical steroid used as an anti-inflammatory and Tretinoin, an acid which increases cell turnover. Tri Luma comes in a tube that will last approximately eight weeks. I used Tri Luma for my melasma and it definitely worked to even out my skin tone and made my skin feel much smoother. But, during the eight weeks I did experience dryness, some sensitivity, and a bad acne break-out immediately following treatment. After everything cleared up, my face was much lighter, smoother, and my HUGE pores had been minimized. The "dirt" was gone!

Other treatments used for melasma include Azelaic acid which possibly decreases the activity of melanocytes (pigment-producing cells). Chemical peels using glycolic acid may also help to reduce the darkness of melasma.

After finishing my round of Tri Luma, the results lasted for less than a year before I began to see the darkness returning. I use a moisturizer with an SPF 30, but the spots were returning anyway. Disappointing when a tube of Tri Luma usually costs around $130! But in defense of this useful product, I did not use a maintenance product of any kind after finishing the tube. Unfortunately it seems that once you have the melasma, it never totally goes away and returns full force if you fail to continue using some kind of fade cream (and SUNSCREEN!)

Enter Vivité Vibrance Therapy by Allergan. My aesthetician introduced me to this product about five months ago and it is the absolute best! It does not have the side effects of Tri Luma and it is light enough to go under makeup without creating a heavy, greasy feeling. Once the dark blotches have faded though, using this product just once every night provides more than enough maintenance to keep the darkness away. The only drawback is the price, it's up there with the Tri Luma, coming in around $120 per bottle with tax (its not a prescription). But the bottle will last longer than the 7-8 week tube of Tri Luma, longer still if you're only using it as a maintenance product once a day. I also checked Ebay and found some up for auction for around $70-100. Be careful though and find out the expiration date for the bottles being offered online.

Some of the ingredients and benefits of Vivité Vibrance Therapy include:

• A natural botanical to help with dull, uneven skin tone
• Retinol, glycolic compound to help exfoliate pigmented skin
• Several natural antioxidants
• An anit-irritant complex
• Proprietary GLX Technology to stimulate collagen and protect epidermal cells
• Humectants/Emollients to hydrate, smooth, and soften skin.

In this line of products they also have an Exfoliating Facial Cleanser, Daily Antioxidant Facial Serum, Night Renewal Facial Cream, and a Revitalizing Eye Cream. There are also other cleansers and moisturizers available.

It may not work as well for others as it has for me, but this product is well worth its price in my experience with it so far. After trying the whole gamut of options - over-the-counter, Tri Luma, chemical peels, and finally Vivité Vibrance Therapy - I have found a keeper.