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.