2/09/2011

Melasma & IPL Fotofacial Treatments - Worth the Pain, Cost & Risks??

Melasma sucks. It is difficult to treat, it is unsightly, frustrating and just plain embarrassing to those of us who suffer from it.



Not my face/photo - photo from webmd.com

What is Melasma? It is brown and grayish-brown spots on the skin, most often on the face and arms. It can also include hyperpigmentation (lighter spots). It is often referred to as the 'mask of pregnancy' because many women get it after being pregnant.  The main causes are pregnancy, hormones or hormone therapy, birth control pills, and medications which make the skin photosensitive to sunlight. Read more about it at the American Academy of Dermatology website.

Many women spend hundreds of dollars to battle Melasma, only to never really see significant results, as it is so difficult to treat. Exposure to the sun worsens melasma, and using creams to treat it makes the skin even more vulnerable, increasing the need to use sunscreen and shield the skin from sunlight. Some creams temporarily lighten skin but spots eventually return, maybe even darker or grayer. Certain cosmetics like Dermablend can help cover it fairly well, but aren't cheap and can look too heavy. It's a viscious circle and many women end up very frustrated. Some sources recommend hydroquinone creams but other sources report that it has dangerous effects on the liver, thyroid, adrenal glands and could contribute to lukemia. Some doctors recommend IPL (Intense Pulse Light or Fotofacial) treatment or Fraxel Laser treatment while other reports I've seen say results are temporary or may make melasma worse.

I have been fighting melasma for about 10 years. I've never been pregnant; my melasma was caused solely by birth control pills taken to combat endometreosis and sun exposure. It has grown significantly worse in the last 3 years. I have tan and brown spots and patches on both cheeks and I cannot seem to get rid of it. I have lightened it somewhat over the years with expensive hydroquinone creams but it has always returned. I sampled TriLuma and the spots grew darker. So, I started using expensive Meladerm for the past 3 months, and have seen only very minor improvement. Additionally I have been wearing 110 SPF facial sunscreen every single day, applying it liberally on my face neck and decollatage area. I feel like the sunscreen is protecting my face and prevents new damage - but the old/existing spots remain. It is quite distressing and humiliating. I am so self conscious of it, I refuse to leave the house without full makeup which covers it pretty well. I am so tired of this. I miss the beautiful skin I had when I was young and would love to wear a lot less makeup.

When I went to my dermatologist yesterday for my annual skin cancer check up, he recommended the IPL treatment for my melasma. He said that it would probably take 2 treatments, for a total cost of about $600 and that it should significantly lighten my spots. Doc explained the skin would be tender for a couple days, would look slightly darker after IPL treatment but would flake and peel naturally, and in a month the newer healthy skin would emerge and be lighter and brighter. He said there is a small percentage of patients who experience their spots actually darkening, and some who saw no improvement, but this number was very small. He felt it was a good option for me. He offered me the chance to get a free test spot done, so we could see how my skin reacted. Eager to try something that might work, I agreed. So, his laser technician used the IPL to do a small spot on my face on my upper right cheek. It felt like a small electric zap or maybe about as painful as the first bite of a tattoo needle. But it lasted only a few seconds. The spot is a bit smaller than a pea, and was a tiny bit sore that evening. This morning I washed my face, and lightly scratched at the area with my fingernail. A tiny bit of brown skin came off, revealing a slightly red patch underneath. I avoided putting my Meladerm lightening cream on this area, but still used it on the rest of my face, as well as my 110 SPF cream and makeup. The IPL treated spot has felt fine since, and does look slightly darker than before. They took a macro-close up shot with a digital camera so we can compare to my face for results when I come back in 30 days for follow-up.

I did not research IPL treatment before agreeing to the test spot. I decided to search online tonight for information and results. I was shocked to see a few websites where some doctors cautioned that IPL was not an effective treatment for melasma, and it could make it much worse. I found others that claimed it was effective or might provide positive results. The more I read, the more confused I am. I am not sure if those who promote it just want to sell a service for profit or if they truly have had good, safe results in their patients. I am thankful that I only had a tiny spot done and hope in 30 days I will like the way it looks. For now, I am not making any decisions about proceeding with further treatment just yet.

Do you have Melasma? Tell me your story.

If you have had IPL treatment for moderate melasma, I would love to hear your story, and your results. I wish I could hear from an experienced practitioner who has been using IPL on melasma patients and hear what your honest, actual results have been and whether you recommend it. There are so many opposing views, it is hard to know what to believe.

22 comments:

mmc67 said...

Thank you for this info, I have a good friend with the condition I wll pass it on to. nice post I am your newest follower, feel free to follow back www.thatshakerofsalt.com

The Redhead Riter said...

"for a total cost of about $600 and that it should significantly lighten my spots."

I don't know about this treatment, but I wonder if there are other treatments that could also help. Things that removed a few layers of the skin...dry ice, laser, etc.

I'm glad you did just a small spot. Before you have the rest done, even if you like the results from the patch, check with another dermatologist about other treatments like I mentioned above.

Things on our face can make us crazy with self-esteem issues. Remember, if we are lucky enough to make it to 85, we will be happy just to be alive and a few spots on our face or an aching bone here and there will be the least of our worries (wink)

You are beautiful inside and that is what really counts!

Retro Girl said...

Thanks for the follow MMC67! I'm coming to check out your blog and follow...I'm abeach party kinda person too - we may have a lot in common! :-)

My fellow Redhead friend *hug* Thanks for the kind words. I am gonna check out some other options...thinking of talking to another Derm who does a clinical chemical peel and just see what they have to say, and gather more info.

Right now my tiny spot in less than 1 week has turned into a light red slight scab, but it's healing. Am hopeful that it will fade once that is gone...I can't imagine my whole face looking like this spot---this has been a learning experience with one tiny spot so far!!

Tara said...

hi, what are your results on your test spot? ...and did you decide to go through with treating your whole face? i have had a similar journey to you in trying to sift through all the online information and make an informed decision about how to approach treatment. i've tried hydroquinone, tretinoin, and microdermabrasion (not in combination, all in different years) over the last 5 years. still there. i have problems with acne i keep at bay with a rigorous skin care regimen and steadfast faithfulness to the handful of products and cosmetics that have proven to not cause breakouts. so i am naturally hesitant to try dermablend and just suffer with the embarrassment of this highly visible imperfection. please update us! i'm desperate for at least one first-hand account from a real person.

Kristi said...

I have moderate melasma, obviously get worse with sun and has lightened and darkened with the seasons over the last couple of years. I had my IPL test patch done 3 days ago and was terrified at the result (big dark brown patch) and that I'm thinking this is what my entire face is about to look like!! This morning the dark patch had "broken up" Somewhat? Looks like it's loosening maybe? But I'm going for the whole face THIS AFTERNOON in about 4 hours to be precise. I'm really worried, and not even of the eventual product but of the next few weeks and looking like a freak! I work full time and cant take time off. AARRGHHH. I'll keep u updated. Wish me luck!

Meredith said...

I would love to know the outcome of what everyone is doing. i have been battling melasma for about three years and it seems never ending. even my friends are sick of hearing about it! I have seen significant improvement with Jessner and 15% TCA peels, but I would like to get the other age spots off my face as well, and it seems like IPL would be the easiest (if I didn't have melasma). I too am thinking about doing a test spot on my face to see what happens. I had a laser treatment in Taiwan with a Q switched alexandrite laser (usually used to take off tatoos) and the results were really good - but I can't find anyone that uses the alexandrite laser in America. I am thinking of going to a tatooo removal place and seeing what they can do with and ND: YAG. So many options but at least the peels are helping a lot and there is always make up. I would to follow up with y'all. Tell me how things turn out, especially Kristi.

Mandi- (everyone needs one!) said...

Hi, I am a Medical Aesthetician. I live in Houston, TX... one of the largest areas to treat Melasma in the US. I have worked with dermatologists for 6 years and I have found a procedure to treat Melasma. It is called: The Melanage Peel. This has been a huge blessing for all my Melasma patients. It can be used on any skintype 1-6. The results are truly amazing. I have had atleast 80% reductions on all of my patients who have done this procedure. I advise you to contact SkinLuma (the makers) and see who in your area preforms this procedure. Hope this helps. ;-)

Kristi said...

So the very last of the dark "scabbing" has disappeared completely today. In all honesty it was probably 4-6 days where I wore heavy make up to cover the immediate effects of the IPL. After that I've barely worn makeup because I love my new face sooo much!! It hurt, and it didn't look great for nearly a week, but definitely all worth it, I'd do it again in an instant. If u look closely u can still see some of the melasma but I think having the darker "age spots" made the melasma patches look worse and they have all responded really really well! The thing is I'm a pretty healthy 36 year old who hadnt left the house without makeup for 3 years, I went to work today with nothing but tinted moisturizer and mascara!!

Anonymous said...

Hi! I would say don't risk it. I've been scarred by ipl, you can get lots of information from realself.com and from ipl and laser damage support forum. I did it, and the damage and scarring post treatment can show up any where from 12months to two years. Ask yourself if it's worth, I hope you don't do it. Lasers heat the dermis, and if something goes wrong, the dermis does not regenerate. I learned the hard way. All the best-claudia

Anonymous said...

Hi there, how are your results holding up now? Would love to see some photos if you have them? I have terrible pigmentation, particularly on my forehead and it has worsened since having our second child. I can completely relate to the feelings of frustration and embarrassment - I feel terrible about myself with this awful patchy discoloration. Gone are the days when people always used to comment on what beautiful skin I had! Hard to believe this used to happen when I look at what it's like now. Quite depressing!

Anonymous said...

I had ipl treatment done and now my melasma is much bigger and darker!!

Anonymous said...

IPL treatments brought my melasma to the surface. I have 6 treatments over the past 2 years. Most recently my melasma came to the surface and the technician told me that the IPL would not work on melasma. The manager of the company told me an option was to complete my IPL package then do something else for the melasma, even though the IPL will make it worse.

I regret ever doing any laser treatments to my face. Before my first treatment 2 years ago, my face had some brown spots but did not look as bad as it does now. I believe the IPLs damaged my skin and now the texture has changed, my skin is red, blotchy, and I have melasma.

Btw, the technician told me that IPLs can sometimes bring up melasma, AFTER it came up!!!

I would avoid lasers and just stick to facials and microderm.

Thanks for your post - I feel your pain!

Kristy Martin said...

I've underwent a Toronto Photofacial treatment and definitely worth everything!
My skin looks much better and finally, after a long time, I've got rid of the imperfections, which were really annoying. Plus that it wasn't that expensive, everyone can afford it!

Anonymous said...

Hi I have melasma and I hate it! I bought an ipl package off of groupon to help with it. When I got to the clinic today the anethescian saw and said it wouldn't work for me. I was very disappointed but she still did ipl all over my face. More I hope it doesn't get worse! I have also been using the Garnier dark spot corrector for about a month and it does seem to have lightened the spots a little bit. My doc. Also prescibed the hydroquinone 4% which I picked up today do I'll be using that too. I just hope it doesn't get worse with the ipl and now I don't know if I should finish the last 2 treatments???? Help !

Retro Girl said...

Anonymous - of July 7th…Did you get the last 2 treatments? What ended up happening? I never went back and got any more IPL other than that test spot….and the test spot is STILL brown 2 years later. i've used various Vitamin C creams, gels and other hydroquonine products, home chemical peels etc - and my spots have only slightly lightened. I continue to use 100 SPF facial moisturizer by Neutrogena daily - and it helps them not get worse for the most part…but I am convinced once you have medium-dark Melasma - you will always have it. I could be wrong but that's my experience. I use Dermablend foundation to cover it and it works fairly well…but I have to touch up at the end of the day. I miss my beautiful peaches and cream complexion that I had in high school before taking birth control. If I knew then what I know now -- I would NEVER EVER take birth control pills of any kind. They ruined my face. SO NOT WORTH IT!! I'd love to hear more of your results and experiences folks.

Anonymous said...

Just had my IPL treatment today! I have melasma terribly on my forehead and left cheek (driving side). 2 more treatments to go! No side effects as of yet. Just feels like a sunburn on my forehead. I'm hoping the results are good!

Anonymous said...

I never went back to finish my ipl treatments, I'm t0 scared it'll get worse! I've just been using the hydoquilone 4%. I feel like it got lighter but then over summer I feel it went back to dark from being in the sun even though I wear sunscreen on my face. O guess I'll go buy the spf 100. Been thinking about going to get a chemical peel but I'm afraid of the healing process, what it'll look like as I peel because I've seen some dramatic peeling on youtube videos. Also damaging my face even more! I too miss my even toned skin :-( anyone had some chemical peels done that can share what they went through?

Anonymous said...

Also I feel like I notice it more in pictures and it might just be me going straight to looking at my cheeks. Some people say they don't notice it but I sure do! Lol!

Ashley Starlie said...

Thank you for posting......

Annika Granberg said...

Thanks for sharing! It was good reading. I have melasma on my chin. And I noticed it two years ago after sunbathing in Italy - when I came in that afternoon my chin was brown. So after that I've be using higher protection like SPF50. The only explanation I have for this is the sun. No pregnancy (for the last 10 years) and no birth control pills like in 20 years. There is not so much research done in this area. I just got the recommendation for IPL treatment but I don't dare now. Thanks again for this info!

Unknown said...

I too a licensed certified medical esthetician. I had the melange peel done for my severe post pregnancy melasma 2 yrs. after I gave birth. Downtime was severe, did not/could not leave house for almost wk. Results were great, but didn't even last a year before it was back, the exact same. Even with a vigilante skin care regimen and sun protection.

Amy Smith-Olson said...

I am a licensed certified medical esthetician and have battled severe melasma for 8 yrs. I have literally tried EVERYTHING! The two things that work to keep it the lighest is a yearly 30% TCA peel and a product called Essential by Naimion. Also you have to use physical sun blocks; at least 20% zinc oxide w/titanium oxide. NEVER chemical sunscreen!!!!

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