Dermatological Treatments
Melasma (Freckles)
Patches or melasma, as is the official medical term, are very common skin lesions, usually brown or grayish-blue in color, which occur mainly in women of reproductive age. They appear on the face and especially on the chin, the upper lip, the cheekbones and the forehead, without this implying that they can not appear in the body as well. According to surveys, 50 million people worldwide have melasma, 90% of whom are women.

The pathophysiology of melasma is still unclear. Certainly, sun exposure is one of the most important factors. However there are other factors, such as genetics and hormones. They are rarely seen and equally rare is the implication of some medicines and cosmetics, such as contraceptives, salicylic acid and fragrances.
Extreme exposure to sunlight, acute or chronic, is an extremely aggressive factor for melasma because of its effect on melanocytes. Melasma is always located in areas of the body exposed to the sun. Ultraviolet radiation generates cell membrane lipid peroxidation and free radical production, which in turn increases the rate of proliferation and migration of melanocytes, as well as triggering melanogenesis. 

How Is Melasma Treated?
  • Bleaching creams containing hydroquinone, retinoids, azelaic acid and colchic acid. These creams help to improve and discolour patches without extinguishing them. However, they can cause skin irritation if used in the wrong way.
  • Chemical peeling which may contain salicylic, glycolic or trichloroacetic acid as its main ingredient. It is the doctor who chooses the appropriate component based on each patient's phototype. Careful attention is needed in its application, as there is the risk of irritation and post-inflammatory hyperpigmentation.
  • Dermabrasion, which is like exfoliating the skin with a special device depending on the size and depth of the problem. Dermabrasion removes the piece of skin that presents the problem and skin is regenerated. There is always the fear of side effects, such as tingling, redness and peeling of the epidermis.
  • Fractional Laser is the most effective way of eliminating melasma. Laser has the capacity of penetrating the deepest layers of the epidermis, causing multiple micro-injuries to the epidermis through thermal energy without affecting its entire thickness. So the risk of post-inflammatory hyperpigmentation is noticeably reduced.
By inhibiting the action of hyperactive melanocytes, laser achieves the degradation of discoloration, and prevents its reoccurrence for a long time, in some cases permanently. Few sessions are required, as the laser action is rapid. Minimal side effects are observed, and the likelihood of recurrence of melasma is greatly reduced.
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