Summary
Highlights
Melasma has various causes, including genetic predisposition, hormonal influences (pregnancy, childbirth, oral contraceptives), UV radiation, skin irritation, inflammation, and certain medications. UV radiation is particularly significant as it leads to photoaging, damaging skin fibers and contributing to deeper pigmentation.
UV exposure causes a phenomenon called solar elastosis, where the skin's dermal layer and its fibers degenerate. This damage extends to the dermo-epidermal junction (basement membrane), creating gaps through which melanin-producing cells can descend. The skin reacts to this damage by producing more melanin to protect itself from further UV damage, explaining why melasma-affected skin often shows signs of significant aging and damage.
While traditional toning treatments can lighten existing pigmentation by destroying melanin, they don't address the underlying dermal damage. Simply removing pigment without regenerating the damaged dermis is akin to treating the symptom without curing the disease. The skin will continue to produce more melanin as a protective mechanism, leading to recurring melasma.
Studies show that treatments focusing on dermal regeneration, such as InMode Forma and fractional radiofrequency, can significantly improve melasma. These treatments rejuvenate the aged and damaged dermal cells, leading to a reduction in pigmentation and an overall improvement in skin condition. Combining these regenerative treatments with toning proves to be more effective than toning alone.
Melasma is a complex condition influenced by various factors like UV, hormones, and dermal aging. Therefore, it's crucial to seek treatment from a board-certified dermatologist specializing in pigmentation disorders. They possess the necessary understanding of the underlying principles and advanced skills to provide appropriate and effective treatment, preventing potential worsening due to improper care.