Pigmentation Treatment

Hyperpigmentation commonly caused by prolonged sun exposure, hormonal fluctuation and skin injuries such as acne, eczema, insect bite reaction (Post-inflammatory hyperpigmentation PIH)

Types of Pigmentation:

1. Melasma

It is a common, recurring with irregular patches of brown pigmentation commonly found on the cheeks, nose, temple, forehead and upper lip area.  It is more likely to occur in darker skin tone lady more than 40 years of age.

Causes of Melasma:
  1. Pregnancy, birth control pills or hormonal therapy
  2. Sun exposure
  3. Thyroid disease
  4. Stress
  5. Genetic
Treatment of Melasma:
  1. Triluma Cream:
    It is a combination cream of tretinoin, hydroquinone and steroid into one. Tretinoin reduces the skin thinning effect of steroid and facilitates the skin penetration of hydroquinone. The steroid cream reduces irritation from tretinoin.  Effect of Triluma cream may be observed as early as 4 weeks.  A study showed 73% cleared at 1 month, 81% at 12 months with excellent safety profile over 12 months application of cream.  It is applied once a day at night.
  2. Picosecond or Q-Switched Nd Yag laser.
  3. Oral Tranexamic Acid:
    A hemostatic agent is effective in the treatment of Melasma with good result seen as early as 2 months into therapy. A retrospective study done in Singapore on 561 patients with 90% showed improvement, but it may relapse when discontinued. It should be vigilant about screening patients for risk of thromboembolism disease, heart disease and stroke.
  4. Melan: Off Peel.
    A professional treatment that helps the elimination and reduction of all type of melanic blemishes in a quick, secure and effective way. It is a topical whitening procedure to eliminate and reduce all kinds of hyperpigmentation of melanic origin.
  5. Sunblock, avoidance of sun exposure, stop hormonal therapy or pill.

2. Post-inflammatory hyperpigmentation (PIH)

PIH developed as a result of injuries or inflammation such as acne, cut, insect bites, eczema, etc.  It occurs more often in darker skinned individual.  It can occur on the face, body, limbs, chest and back.  The older we get, the slower the healing rate, the longer the pigmentation will stay.  PIH occurred on areas other than face, has high tendency to stay permanent.  It may not fade off with time.

Treatment with laser is probably one of the best options to treat PIH effectively.  Generally it takes 5-10 sessions to see significant improvement.

3. Freckles

They generally do not respond to topical cream but can be treated effectively with laser.

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