Dr. Simran Sethi:
Do topical creams really work for melasma? This is a very interesting and important topic, especially if you have melasma or you’re someone who treats melasma in a medical setting or if you’re an aesthetician who has a client with melasma. And again, if you enjoy learning about these kind of topics in medical aesthetic, skincare, even just beauty trends, please follow, like, and leave us any questions in the comments. Welcome to the New Skin Report, a dedicated space for exploring the world of skincare, medical aesthetics, and beauty, especially for women of color. We are bringing the same insightful discussions into a vibrant new format where you can both hear and see the world of skincare and medical aesthetics come alive. So join us on the New Skin Report. Let’s explore, learn, and grow together. Hit subscribe and let’s make skincare and self-care a journey we embark on together.
Going back to our topic, melasma is a very complex condition. It’s most common in skin of color and more common in women. We know a lot about melasma, but we don’t know how to directly eliminate it. What we do know is that melasma is something that is worsened with exposure to heat, light, and skin barrier breakage. Now, going back to our topic, do topical treatments or creams actually work on reducing the appearance of melasma? The answer here is yes and no, and that depends on the depth of the pigment that the patient has or your client has with melasma. In melasma, the condition basically involves overproduction of melanin pigment in the epidermis, which is our most superficial layer. There is so much pigment production that the pigment starts falling into the dermis, which is our deeper layer. And the dermis’s job is not to house pigment.
It is only designed to hold collagen, produce collagen, elastin, all our skin proteins. When people have melasma, they have overproduction in the epidermis, so it can’t hold all that pigment anymore. Then they also have a broken membrane that normally separates anything between the epidermis and dermis. So going back to topical, topical treatments work primarily in the epidermis. So if someone has early stages of melasma or mild melasma, they actually are very responsive to topical creams that include hydroquinone, vitamin C, kojic acid, azelaic acid, and there are a few others. However, if they’ve had melasma for a while or have more advanced melasma, they likely will have limited response to topicals because a lot that pigment is sitting in the dermis and topical treatments or creams do not reach the dermis.
When they do have that, there are some options. Doing treatments like PicoSure pro laser, microneedling does help regenerate a lot of new collagen which then starts moving this pigment up into the epidermis for a better chance at getting rid of it. So when you are working with someone with melasma, it’s important to make them understand that topicals may or may not work. They are definitely a good option and something that typically do work if you are in the early stages of melasma or have mild melasma. If you enjoy learning about medical aesthetic treatments, skincare, beauty trends, please like, subscribe, and ask us any questions in the comments.
