Melasma is also known to be associated with the use of certain medications such as birth control pills, hormones, or
photosensitizing drugs. Individuals who frequently use fragrant cosmetics may also develop melasma. In my experience as a
facial plastic surgeon, patients with low antioxidants in their diet also seem prone to melasma as well.
Certain other factors definitively worsen melasma. Exposure to sunlight, for example, significantly worsens the condition.
Over the years, I have known numerous patients with melasma which got much worse after their vacation in sunny places
during the summer. And indeed, in my experience, any inflammation which results in excessive or prolonged redness further
exacerbates melasma.
Melasma is the most stubborn skin discoloration of all. Melasma in the superficial layer of the skin called epidermis is much
easier to treat, while melasma in the deeper layer called the dermis is much more difficult to improve. As we shall discuss
later, treatments rely on state-of-the-art prevention and reduction techniques.
So when you have another child, start to take birth control pills, or you are approaching menopause, take aggressive steps, as
we shall discuss later, to prevent melasma.
Post-Inflammatory Hyperpigmentation (PIH):
The Curse of Inflammation
Does your skin get easily hyperpigmented after an injury? Look at your old scratches or acne and if they stay dark for a long
time then your skin is prone to PIH.
Darker skin type can easily develop PIH from any inflammation. As such, any condition which produces inflammation can
cause PIH. The causes are obviously numerous. Some of the most common ones include acne flare-ups, allergy, irritation
from any source including harsh lasers and peels. And just like melasma, both UV irradiation and certain drugs (for example,
tetracycline) worsen this condition likewise.
Facial post-inflammatory hyperpigmentation is also challenging to treat but is easier to cure than melasma. Just as in
melasma, however, epidermal PIH is much easier to treat, while dermal PIH is much more difficult to improve.
So next time you get laser and peel treatments for your skin without proper sun protection and skin products preparation,
watch out for PIH and think of prevention first!
Combination of Melasma and PIH
Both melasma and PIH can co-exist, since many of the aggravating factors are the same. Treatment is more challenging when
these two conditions are present in a patient.
In summary, melasma and post-inflammatory hyperpigmentation are unsightly and challenging skin conditions. In today's
culture where people, particularly women, pursue beauty treatments such as skin whitening and flawless skin tones, the
desire for modern and better solutions for all their skin concerns increases.
In the succeeding articles, we shall discuss the state-of-the-art methods both to prevent and to fade pigmentation so you can
have brighter looking skin!
ASEAN Life • MAY 2016 | 29