Melasma, also called ‘chloasma’ and ‘pregnancy mask’, is a common skin condition in which brown or greyish patches of pigmentation (colour) develop, usually on the face. The skin patches that form are usually darker than your natural skin tone. Melasma is more common in women, particularly during pregnancy (up to 50% of women may be affected). Sometimes, men may also be affected. Melasma is more common in people of colour and those who tan very quickly however, it can occur in anyone. Melasma usually becomes more noticeable in summer and improves during winter. It is not an infection therefore it is not contagious and not due to an allergy. The skin condition is not cancerous and will not develop into skin cancer.

WHAT IS THE MAIN CAUSE OF MELASMA?

The exact cause of melasma is unknown; it is thought to be because pigment-producing cells in the skin (melanocytes) produce too much pigment (melanin). Several factors can contribute to the development of melasma: pregnancy hormonal drugs such as birth control pills and hormone replacement therapy thyroid problems that affect hormones (this is rare) other medications (anti-epileptics) exposure to ultraviolet (UV) light from the sun and the use of sun-beds or phototherapy Melasma is more common in people with a family history of the condition, but it is not hereditary.

WHERE DOES MELASMA NORMALLY APPEAR?

Melasma typically occurs on the face and is symmetrical, with matching marks on both sides of the face. Brownish/greyish coloured patches usually appear on the: cheeks forehead upper lip bridge of the nose chin Other areas of the body, that are often exposed to the sun, can also develop melasma such as the neck and forearms. The skin discoloration doesn’t do any physical harm but the skin condition may cause self consciousness.

WILL MELASMA GO AWAY?

At present, there is no cure for melasma but it may go away on its own. This usually happens when the trigger that causes melasma, such as pregnancy or a medication stops. There are several treatment options which may reduce its appearance. The first step in treating melasma is confirming with a dermatologist or skin specialist that your darkened skin patches are indeed melasma and determining what is causing it. Treating melasma is unlikely to be effective if the underlying cause isn’t addressed. Melasma can also last for years or even a lifetime. While melasma cannot harm your body, it is understandable that many people want to treat it.

Post Inflammatory Hyperpigmentation

What is Post Inflammatory Hyperpigmentation (PIH)?

Post-inflammatory hyperpigmentation (PIH) is the darkening of the skin in an area of prior injury or skin disorder. The discolouration is due to the production of excess melanin (pigment) as part of the skin’s natural response to inflammation. The darkening may also be due to an iron pigment left behind when old red blood cells die. Acne is a common cause as well as any type of skin injury, such as those caused by aesthetics treatments, or skin disorders, such as eczema.

PIH usually looks like a flat area of discolouration on the skin. It can appear white, pink, red, purple, brown, or black, depending on skin tone and the depth of the discolouration. Post Inflammatory Hyperpigmentation can develop in all skin types. However, it tends to be more severe and longer-lasting for people with medium to dark complexions. People of colour have more pigment (melanin) so there is more of a chance of post inflammatory hyperpigmentation with certain skin problems. PIH is one of the most common reasons why people with darker skin seek the advice of a dermatologist.

An injury, rash or blemish causes the skin to become inflamed. This inflammation triggers melanocytes – the melanin-producing cells – to release excessive melanosomes (pigment granules). The excessive pigment granules darken and discolour the formerly wounded area, remaining there long after the initial wound has recovered.

The more inflammation there is, the more obvious the area of discolouration will be both in terms of size and colour. In cases where PIH is caused by acne, picking pimples can worsen the skin condition, leading to increased hyperpigmentation.

What Causes Post Inflammatory Hyperpigmentation?

Sun

The sun can aggravate symptoms of PIH, darkening the affected patches and prolonging the time it can take for them to fade. The sun is closely associated with other forms of hyperpigmentation such as age/sun spots and melasma.

Wounds or Irritation

PIH develops when a wound or irritation (a scrape, rash, or pimple) causes the skin to become inflamed. As the skin heals, it produces too much melanin which darkens the skin.

Sunburn

Sun exposure without sunscreen or sun protection can make PIH worse by stimulating cells in the skin to produce additional pigment, which is why it is important to wear sunscreen or avoid sun exposure when you have a skin injury.

How Do You Get Rid Of Post Inflammatory Hyperpigmentation?

Post-inflammatory hyperpigmentation does not cause scarring and even with no treatment, it will improve over time. Recovery rates vary from person to person: the timing depends on the difference in skin tone between the natural skin tone and the darkened patches – the more significant the difference, the longer it will take for the uneven skin tone to rebalance.

Do Chemical Peels Cause Post Inflammatory Hyperpigmentation?

Post inflammatory hyperpigmentation can both be cured by and paradoxically caused by a chemical peel. Due to The Perfect Peel’s blend of multiple acids combined in low percentages, the risk of developing PIH is decreased, compared to other chemical peels.

Hyperpigmentation usually occurs on areas of skin where the deepest parts of the peel are found. PIH will only affect the areas of skin that have been treated with a chemical peel (although this is very rare).

Post Inflammatory Hyperpigmentation Treatments

Your skin professional will be able to advise on effective topical agents for reducing post-inflammatory hyperpigmentation

Hydroquinone

Hydroquinone is a widely used treatment for PIH and available on prescription in the UK. Hydroquinone works by blocking the enzyme responsible for melanin production, thereby lightening the skin.

These creams often contain additional lightening ingredients, which can give you better results than using hydroquinone alone. Ingredients combined with hydroquinone include:

Kojic acid (a chemical made from fungi)
Glycolic acid
Tretinoin and other retinoids
Vitamin C

ASK YOUR PRACTITIONER ABOUT THE PERFECT B CREAM.

Retinoid Creams

Retin-A (tretinoin)
Retin-A Micro
Tazorac (tazarotene)
Differin (adapalene)

ASK YOUR PRACTITIONER ABOUT THE PERFECT A CREAM

Azelaic Acid

Azelaic acid is another ingredient used to treat PIH. It works by decreasing inflammation and speeding up cell turnover rates. Azelaic acid is sometimes used along with glycolic acid or tretinoin.