Melasma is a common skin disorder characterized by irregular patches of shades of brown or gray that develop on the skin’s surface. It predominantly affects women aged 20 to 40, particularly those with Fitzpatrick skin types IV to VI, such as Hispanics, African Americans, Africans, and Asians. Often referred to as the “mask of pregnancy,” melasma affects 15 to 50% of pregnant women. While it may not be a rare condition, it poses significant challenges to treatment, especially in individuals with darker skin tones. Fortunately, various chemical peel solutions are available to help address this condition effectively.

Understanding Melasma

Melasma is an acquired disorder of hyperpigmentation that affects the skin’s quality of life and is challenging to treat. It is described as a notorious dermatosis, often resistant to treatment. Melasma is a skin condition triggered by an over-activation of melanocytes, the cells responsible for producing melanin in the skin.

Melasma and Skin Pigmentation

Melanin is a naturally occurring chemical responsible for pigmentation in the body. The amount of melanin produced by melanocytes determines the color of your skin. Melasma occurs when melanocytes in the epidermis are triggered to create more melanin. This overproduction of melanin leads to patches of excessive pigmentation or discoloration on the skin’s surface.

The Causes of Melasma

The exact cause and etiology of Melasma are yet to be fully understood. However, the most commonly identifiable risk factors include ultraviolet radiation, genetic predisposition, pregnancy, oral contraceptives, thyroid disease, and certain drugs like antiepileptics. Excessive pigmentation has been attributed to melanocytosis (increased number of melanocytes) and melanogenesis (excess melanin production).

Treating Melasma: The Role of Chemical Peels

Chemical peeling is a well-known treatment modality for melasma. It has shown promising results in many clinical trials. However, in darker races, the choice of the peeling agent becomes relatively limited. This is due to the increased risk of post-inflammatory hyperpigmentation (PIH). The treatment ranges from easily applied topical therapies to more extensive ones like lasers and chemical peels.

Understanding Chemical Peels

Chemical peels are skin resurfacing treatments that remove the epidermis, the outermost layer of skin, through controlled destruction. This process regenerates new epidermal and dermal tissues. Chemical peels come in many different forms, typically varying in strength and application according to the patient’s skin type.

How Do Chemical Peels Work?

Chemical peels work by causing controlled epidermal dyscohesion and subsequent regeneration. The peeling agent causes superficial effects, enabling the removal of epidermal melanin and melanin from the keratinocytes, halting melanosome transfer to keratinocytes. This makes it an indispensable modality in treating melasma.

Types of Chemical Peels for Melasma

There are a variety of chemical peels that can be used to treat melasma. These include Alpha Hydroxy Acid peels (such as Glycolic acid and Mandelic acid), Beta Hydroxy acids peels (such as Salicylic acid), and combination peels like Jessner’s solution and Tretinoin peels.

Alpha Hydroxy Acid Peels

Alpha Hydroxy Acid (AHA) peels, such as Glycolic acid (GA) and Lactic acid (LA), are the most commonly used peels for melasma. GA peels are usually used in a concentration of 30%–70%. Weekly sessions are conducted for a series of 4–6 sessions, two to three weeks apart.

Beta Hydroxy Acid Peels

Beta-hydroxy acid (BHA) peels, such as Salicylic Acid (SA) peels, help eliminate epidermal pigment in well-primed patients with melasma. Their lipid solubility improves their keratolytic action and smoother post-peel texture.

Combination Peels

Like Jessner’s solution, combination peels can cause controlled epidermal dyscohesion and subsequent regeneration. The peeling agent causes superficial effects, enabling the removal of epidermal melanin and melanin from the keratinocytes.

The Process of Getting a Chemical Peel

The chemical peel procedure is simple. The skin is cleansed beforehand, removing excess oil and dead skin cells. The agent responsible for the peel is then applied, and it will remain there for several minutes, depending on which medication comprises the peel. After several minutes have elapsed, the chemical is neutralized.

The Efficacy of Chemical Peels for Melasma

Chemical peels for melasma have been shown to be highly effective. They not only lessen the appearance of hyperpigmentation but also prevent melanosome transfer to keratinocytes, making them an indispensable modality in treating melasma.

The Role of Priming Agents

Priming or preparing the skin prior to the peel is a useful adjunctive measure that enhances the effect of the peeling agent and decreases the PIH. It involves applying a topical depigmenting agent like hydroquinone, tretinoin, or GA two weeks before the planned day of the peel.

Choosing the Right Chemical Peel for Melasma

When choosing the right chemical peel for melasma, it is essential to consult with a board-certified dermatologist. This is particularly important if you have a darker skin tone, as many skin-lightening products can harm dark-skinned patients.

Conclusion

Chemical peels can effectively treat melasma, primarily when performed by an experienced professional. They not only help reduce melasma’s appearance but also provide a rejuvenated and healthier skin appearance. If you have been struggling with melasma, a chemical peel may be the perfect solution for you. Contact Las Vegas Skin Pros Med Spa today to see if a chemical peel is ideal for treating melasma!

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Dr. Frank Stile
Dr. Frank L. Stile is a plastic surgeon certified by the American Board of Plastic Surgery. His office is in Las Vegas. The office is luxuriously appointed and has won awards for original designs and decor. His practice provides the full spectrum of cosmetic surgery procedures. Dr. Stile has had the privilege of helping over 10,000 patients achieve their cosmetic surgical goals. Originally from New York City, Dr. Stile graduated high school at the age of 15 and began medical training at the City University of New York’s Accelerated 7-year combined Undergraduate and Medical School Program. He completed his clinical training at the State University of New York Health Science Center at Brooklyn. His post-doctorate training included 12 years of residency. During that time, Dr. Stile received specialized surgical training at four academic institutions of excellence. He is the published author of articles and book chapters in the Plastic and Reconstructive Surgery and Microsurgery literature. He has presented research at National and International Plastic Surgery Conferences. Dr. Stile regularly visits with leaders in the field of cosmetic plastic surgery, facilitating the exchange of ideas and constantly refining his techniques. Dr. Stile has long held an interest in the martial sciences, specifically mixed martial arts. His personal and professional relationships with the stars of MMA have made him the most trusted and requested plastic surgeon by champions of the sport. Dr. Stile has innovated and published techniques for both treating new facial injuries and preventing recurrent injuries in “cut-prone” fighters. His work has been featured in such publications as the New York Times, Maxim Magazine, and Real Fighter Magazine, in addition to numerous television and radio shows. Dr. Stile is an avid illustrator, painter, and sculptor. His work adds to the decor of both his home and office. He is also the published author of two children's books. His greatest accomplishment, second only to being a husband and father, was the establishment of the Frank L. Stile Foundation in 2011. The goal of this non-profit was to serve and support the needs of children in crisis. To date, this initiative has helped provide over TEN MILLION meals for food insecure children and their families in addition to providing resources for medical care.
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