Hyperpigmentation Vs Melasma

1. Hyperpigmentation Vs Melasma: Causes, Symptoms And Best Treatment By admin -June 2, 2023037 Hyperpigmentation-Vs-Melasma Hyperpigmentation-Vs-Melasma Our how-to guide explains hyperpigmentation vs melasma, the common symptoms of each, and the best skincare treatments to use on clients. As we head into summer, arming yourself and your therapy team with the knowledge to treat hyperpigme ntation vs melasma will help you to provide your clients with the best course of action. In this helpful guide, we explain what hyperpigmentation and melasma are, how these conditions present themselves, contraindications to be aware of, and how to treat the skin effectively in treatment and at hom ecare. For a more bespoke focus on how to treat hyperpigmentation and scarring caused by adult acne, then ch eck out this handy guide. Table of Contents What is hyperpigmentation? What is melasma? What should I cover in the consultation? How do I prepare the skin for treatment? How can I effectively treat hyperpigmentation vs melasma? How can I manage client expectations? How should I tailor my homecare advice? Lifestyle adjustments What is hyperpigmentation? “Hyperpigmentation is a term used to describe discoloration on the skin or abnormal darkening of the skin ,” says Maria Rylott-Byrd, facialist and clinic owner based in Alaska, and member of The Skin Collaborativ e. “It is an overproduction of melanin from the melanocytes, and that travels its way up to the surface of th e skin where you see that discoloration.” It can have several causes, one of the biggest being UV damage . “The sun is a huge cause of hyperpigmentation,” adds Rylott-Byrd. “It needs a layer of protection with UVA and UVB protection with broad-spectrum SPF. Medications and h ormonal factors, such as pregnancy and oral contraceptives, can also have an effect.” What is melasma? Melasma is similar to hyperpigmentation but is usually triggered by hormonal factors, be it thyroid dysfunc tion, pregnancy, or hormonal contraception, as well as genetics, UV, and medications. “Melasma appears more in a block formation, whereas hyperpigmentation has a more mottled appearanc e on the skin. And under a Woods lamp, the melasma will appear unchanged under the light,” she says. It ’s also more prevalent in women than men due to the hormonal factors that can trigger it and in ages 25– 40 and those with Fitzpatrick skin type three and four. It’s also harder to treat. “Epidermal pigmentation (solar keratoses) responds well and more quickly to treat ment, while dermal pigmentation (melasma or chloasma) usually takes longer to lighten. Taylor notes that melasma can present in a number of ways, including: Centro facial, which appears on the forehead, cheeks, nose, and upper lip. This is prevalent in 50–80% of presentations of melasma and is also known as the “butterfly effect” Malar, which affects the cheeks and nose Mandibular, which appears on the jawline and chin Erythosis pigmentosa face, which presents as reddened or inflamed. This is vascular melasma and will ha

2. ve a red tinge Extra facial, which can appear on the forearms, upper arms, and shoulders. What should I cover in the consultation? Conducting a thorough consultation with your client is imperative to treat any kind of hyperpigmentation, i ncluding melasma. “It can be genetic, especially peri-orbital and peri-oral. It’s very common that we see a genetic pattern to it, particularly in Asian skin types,” says Dr. Irfan Ahamad, aesthetic medicine doctor, sk in specialist, and member of The Skin Collaborative. “Medication such as tetracycline, antibiotics, naproxen, which is an anti-inflammatory commonly used for osteoarthritis and inflammatory conditions, and psychotics can cause photosensitivity. Therefore, it is very important that we do a thorough consultation to find out about any prescription drugs,” he says. How do I prepare the skin for treatment? Tyrosinase inhibitors are crucial for treating this concern. “Whether the client is Fitzpatrick one or six we n eed to use tyrosinase inhibitors,” says Sarah Hurst, founder of Sarah Hurst Skin Clinic in Brighton and me mber of The Skin Collaborative. “Tyrosinase is the enzyme that increases the melanocyte and melanin pr oduction,” she says, so look to ingredients such as kojic acid, vitamin C, tranexamic acid, azelaic acid, an d licorice root, which can help inhibit melanin production. Moreover, establishing a good homecare routine in conjunction with broad-spectrum SPF is important to p repare the skin for any treatment. “I wouldn’t do any type of advanced treatments in the clinic without heal thy and balanced skin,” advises Rylott-Byrd. “I’d look at the client’s lifestyle and homecare routine and bring together a plan to help the skin have stron g integrity. If we do look at advanced treatments, then we’d want to prepare the skin accordingly; we’ve m entioned the tyrosinase and creating that umbrella over the skin with SPF, and then we need to look at so me kind of exfoliation to shatter that pigment.” How can I effectively treat hyperpigmentation vs melasma? There are many methodologies for shattering pigment and my personal preference is to work with chemic al peels and microneedling, as we can use it across the board, as long as we can get the preparation time right,” says Hurst. “This is because you need nice, hydrated skin, so recovery time is going to be minimiz ed and we won’t hinder any results in any way,” she says. For an enhanced outcome, you should set up your client’s pre-treatment care two-to-four weeks prior to th eir treatment program, advises Taylor. “For darker skin tones, the longer the homecare the better,” she ad ds. “However, depending on the treatment, you may need to ask them to discontinue the products three t o five days ahead, depending on the type of ingredients used.” Whether you opt for micro-needling or chemical peels, a gentle approach is favored. “Starting with a chem ical peel that is gently exfoliating, and building those peels up, is important,” says Hurst. “When you go in f or a deeper peel to get rid of pigmentation quickly, you should also prep the skin thoroughly, firstly at hom e and also with more superficial chemical peels within the clinic, before moving on to anything deeper.” Dr Amado agrees: “We used to treat pigmentation with micro-needling at a much deeper depth than we d o nowadays, but we have to be gentle,” she says. “For hyperpigmentation, I’d use 0.5mm because we do n’t want to stimulate that basal cell too much, as that can cause more pigmentation.” When it comes to laser, Hurst says it’s not her preferred treatment. “With the higher Fitzpatrick colors, it’s very important to be careful with laser due to the fact that pigmentation can be absorbed, so if you are goi ng to be treating pigmentation, it’s better if you’re treating a spot area as you may be able to cover over th e rest of the skin,” she says. “But to overtreat a whole area can be very dangerous, particularly with the ablative lasers. A gentler form of IPL may be preferable, but it wouldn’t be our treatment of choice.”

3. To ensure successful treatment for melasma, the underlying triggers need to be addressed and removed where possible. “If the client is on the contraceptive pill and we think this might be a trigger, then we can tr y giving them tyrosinase inhibitors, but you need to work with the client because you might not necessarily get the best results on somebody who has got the trigger still in place,” says Hurst. “Once that hormonal stimulation has gone, the melasma will generally subside, but it can be stimulated by the sun moving forward, so you still need to practice homecare, the tyrosinase inhibitors, and SPF,” advis es Rylott-Byrd. “You can treat it in the same way, as it is all hyperpigmentation, but you might need to trea t just the area, as opposed to the whole face.” But, whether you’re treating hyperpigmentation or melasma, it’s important to explain to the client that the t reatment process is a partnership between you both. How can I manage client expectations? “A good consultation will explain the science behind it – people are not aware that with two-to-three days of unprotected UV radiation, you will undo everything that you have done for a whole year,” says Dr. Ama do. “Patients need to be committed; if they’re not going to use their SPF or their tyrosinase inhibitors, ther e’s no point in doing chemical peels and micro-needling in a clinic because you will be fighting against it al l of the time,” she says. “On average, it takes about 12 months to reprogramme the melanocytes (the cells that produce melanin), so it is going to be a long program and will need to be maintained.” How should I tailor my homecare advice? There are several ingredients that can support your client’s skincare journey and maintain their results. H urst recommends kojic acid, tranexamic acid, vitamin C, licorice root, azelaic acid, and AHAs such as glyc olic, lactic, and mandelic. “Niacinamide has been shown to help regulate hyperpigmentation and so has vitamin A because it’s such a good skin normalizer, as is green tea,” says Hurst. Dr. Amado also recommends cysteamine. “This ingr edient is also a tyrosinase inhibitor but with no downtime. You can use it long-term and it does not need a prescription,” she says. Using a broad-spectrum SPF is crucial to maintain progress and prevent pigmentation from returning. Whi le many will apply this first thing in the morning, it’s important that clients also top up their SPF protection t hroughout the day. However, some may find SPF irritating for the eye area, or inconvenient to reapply ov er make-up. “My go-to is a physical mineral powder,” explains Hurst. “Many clients say they avoid putting SPF around their eyes as it runs and causes irritation, so mineral powder is brilliant for that,” she says. For those who want to top up their UV protection over makeup, she advises a spray, saying, “There are some good spra ys now, but ideally you want to reapply every couple of hours.” Lifestyle adjustments To keep hyperpigmentation and melasma at bay, Rylott-Byrd recommends discussing the client’s lifestyle habits. “It’s not enough to have an SPF on. If it’s a bright sunny day, stay in the shade and wear a big hat and sunglasses. I see a lot of pigmentation just about where the sunglasses stop, as people tend not to br ing their SPF close to the eyes,” she says. It’s also important to talk through any hormonal factors that could be causing problems. “Clients should kn ow their triggers. For example, if you know you are susceptible on oral contraceptives, perhaps find anoth er contraception method,” she says.