Melasma, every dermatologist and aesthetician frowns because it is a stubborn, unpredictable and temperamental discoloration.
There is no product that can very clearly state that it can remove melasma, but for melasma, it can be improved by a systematic and comprehensive treatment. Here, we will give you a systematic introduction of melasma.
Melasma
Melasma, also known as liver spots, is a common acquired hyperpigmentation skin disease occurring on the face, which occurs on sunburned areas and worsens after sun exposure. It is common in young and middle-aged women. The course of the disease is chronic, with no obvious conscious symptoms.
The disease is seasonal, with a heavy summer and a light winter. The average optical density of the pigmented area is more than 20% of the average optical density of the face.
Typical symptoms
It is more common in women, especially during pregnancy, postpartum, and in women taking oral contraceptives. The rash is symmetrically distributed on the skin of the face, forehead, cheeks, both sides of the back of the nose, around the lips and chin, and appears as irregularly shaped pale brown or dark brown macules of finger cap to coin size or palm size, with distinct or indistinct boundaries, which may fuse into a large area. No conscious symptoms, chronic, aggravated by sun exposure. Some of them may fade away slowly after childbirth or after stopping the use of contraceptive pills.
The disease is easy to diagnose according to the characteristics of yellow-brown spots on the face, more frequent in women, and no self-consciousness.
1.It occurs on the cheekbones, forehead and around the mouth of the face, and is mostly symmetrical and butterfly-shaped, so it is also called butterfly spot.
2. The initial color is like dust and dirt, and deepens with time, turning into light gray-brown or dark brown, withering and dark.
3.Variable size, clear edge of spots, smooth surface, no inflammatory reaction, no pain and itch.
4.Females who often use oral contraceptives and pregnant women will have stretch marks on their face, which is also a kind of chloasma.
5.Women with chloasma mostly have menstrual disorders, premenstrual breast swelling or chronic diseases.
6.Male chloasma patients are mostly accompanied by impotence, premature diarrhea, gastrointestinal disorders, etc.
Causes
Genetic susceptibility, ultraviolet radiation and changes in sex hormone level are the three important factors in the development of melasma, and vascular proliferation, skin inflammation and barrier function disorder at the pigmentation may also be involved in the occurrence of melasma.
1, genetic susceptibility is one of the main factors in the development of melasma, all races can suffer from melasma, but there are racial differences in the incidence rate, the incidence rate of dark-skinned races is higher, and patients with family history are prone to treatment resistance and prolonged treatment.
2. UV radiation in sunlight is considered to be the main factor causing the occurrence and aggravation of melasma, but it is not the only factor in the development of melasma.
3, pregnancy, oral contraceptive pills and hormone replacement therapy are the most common triggering factors of melasma.
4. a significant increase in the number and volume of small blood vessels in the dermal tissue at the pigmentation site, and a significant increase in the expression of local vascular endothelial growth factor (VEGF)
5. decrease in epidermal barrier function, associated with skin aging caused by chronic ultraviolet radiation, reduced epidermal mucin content and impaired fatty acid metabolism.
6. Decrease in epidermal barrier function, which in turn leads to weakened pigment barrier function and disturbance of melanin metabolism, resulting in deposition of melanin particles in the epidermis.
Subtypes of melasma
1.Pigmented type (M): the type dominated by melanin (Melanin).
2.Vascular type (V): the type in which capillaries (Vascular) overflow, crack and expand.
3. pigment-dominant type (M>V): both M and V are present, but M is greater than V.
4, Vascular dominant type (V>M): the role of both M and V, but greater than M.
M is a consequence of inflammation and V is a sign that inflammation is occurring. When inflammation is occurring, the use of laser and other treatments can aggravate inflammation, which in turn makes melanocytes more active.
When there is a mixture of inflammation occurring, the inflammation should be controlled first (dealing with V) and the melanin eliminated later (M). It is easy to identify which type melasma belongs to using the slide press method.
And nowadays, most of the melasma is mixed type. Mixed melasma is difficult to treat, has a long treatment period, and has numerous methods, but there is no characteristic therapy. Here is a brief introduction to the treatment of melasma.
We doctors and patients must pay attention to the basic role of skin barrier function in the treatment of melasma.
Topical medication
To remove melasma, topical medications are essential. For example, Qianbai Hydrogen Kun Cream, Silk White Spot Removal Cream, Pearl Four White Cream, Winona Arbutin Whitening Moisturizing Essence or Liquid, Yifei Astaxanthin Glowing Essence, Tranexamic Acid Babu Patch, Ximax L-vitamin C Essence, etc. If combined with hyaluronic acid, vitamin C, arbutin import can repair the skin barrier, can play a better effect. Or chemical peeling or basic treatment with fruit acids, which can lighten and fade the pigmentation.
Internal medication
Take vitamin C and vitamin E orally daily under medical supervision. Remember not to take vitamin E orally or topically in the morning (this medication has a photosensitizing effect). Also, intravenous glutathione drip (once a day for 15 days, then once a week thereafter) as prescribed by your doctor. Glutathione is a reducing agent that can have a whitening and discoloration effect due to its ability to remove toxins and metabolic waste from the body. There are also tranexamic acid (torsemide), Chinese herbal medicine, Chinese patent medicine, etc.
Laser/Intense Pulsed Light Treatment
Many melasma patients are especially afraid of laser treatment, worrying that laser will stimulate the pigmentation to become more and more serious, and in clinical practice, there are indeed some patients who make melasma more and more serious because of laser treatment.
In fact, the treatment result of melasma is good through comprehensive treatment. After clinical statistics, the effective rate is about 77.5%.
Nano-crystal introduction treatment
Nanocrystal is a new way of drug delivery by breaking the skin, which rapidly opens tens of thousands of tiny channels without destroying the keratin barrier and rapidly introduces active ingredients, and the depth of drug delivery is very easy to control, and the channels will be closed in about 20 minutes after breaking the skin, which will not cause infection and redness and other problems.
Nanomicrocrystals for melasma formulation.
Tranexamic Acid + Glutathione + EGF + Hyaluronic Acid
Daily maintenance of melasma
The treatment of melasma and daily maintenance can be said to be equally divided and must be done with both hands and both hands. Especially, many melasma patients have emotional problems such as anxiety, depression, low self-esteem, etc. These emotional problems will trigger insomnia and mental fluctuations, which are especially unfavorable to treatment.
1. Sun protection: It is crucial to do well in effective sun protection. Sunlight will definitely aggravate melasma, so it is necessary to do a good job of effective sun protection.
2.Reduce stimulation: The destruction of skin barrier and the occurrence of melasma are closely related. For useless care procedures can be simplified, streamline the patient’s skin care products and use the correct cleansing method, which can accelerate the recovery of skin barrier and help a lot in the treatment of melasma.
3.Chinese patent medicines: Chinese patent medicines such as Munizi granules, Easy Pill and Liu Wei Di Huang Wan can be given to patients according to the results of Chinese medicine dialectical treatment to assist treatment.
4.Dietary regulation: Try to consume less photosensitive food, medicinal food and medicinal tea have certain auxiliary effect on the improvement of melasma.