Sunday 21st April 2024
Durbar Marg, Kathmandu

Melasma in fact can fade on its own. This is often the case when the causes for the melasma are pregnancy or birth control pills. By saying this, it means that if a woman delivers a baby or takes the birth control pills, melasma will appear as a result of the mentioned action. So later when the woman delivers the baby or stops taking the birth control pills, melasma can automatically fade.

Different from the case above, many people, however, have melasma which lasts for years or even worse a lifetime. Melasma consequently can seriously affect one’s outside appearance, which leaves the affected people in a very shy and depressing state. If it happens that the melasma does not go away, there are heaps of melasma treatments available out there to try.

Topical agents:

1) Hydroquinone

Hydroquinone can be considered the most frequently prescribed depigmenting agent worldwide. By this, it has become the most popular method of treating melasma. Preparing hydroquinone to treat melasma can be at concentrations from 2 to 5% applied once daily. The depigmenting effects of hydroquinone treatment become evident after 5-7 weeks. Treatment with hydroquinone should be continued for at least 3 months and up to one year. Also in fact, hydroquinone is also combined with other agents like sunscreens, topical steroids, retinoids, and glycolic acids for additional benefits.

What you should be aware are the reversible effects from using hydroquinone for your melasma treatement. Irritation is the most common effect, other adverse effects are erythema, stinging, colloid milium, irritant and allergic contact dermatitis, nail discoloration, transient hypochromia, and paradoxical postinflammatory hypermelanosis. This is what can be seen when treatment of melasma with hydroquinone is at concentrations higher than 2%.

Being questioned about its safety to the users, hydroquinone has been banned in cosmetic preparations in many countries.

2) Azelaic acid

Azelaic acid is an acid initially developed as a topical anti-acne agent, azelaic acid can also be used to treat hyperpigmentary disorders like melasma.

The good news is that a study has shown that a 20% concentration of azelaic acid was equivalent to 4% hydroquinone when treating melasma, but without its side effects. Another controlled study has proven azelaic acid to be superior to 2% hydroquinone. Combined usage of azelaic acid with 0.05% tretinoin or 15-20% glycolic acid can result in earlier plus pronounced skin lightening. Adverse effects of azelaic acid are pruritus, mild erythema, and burning.

3) Kojic acid

Kojic acid is used at concentrations ranging from 1 to 4%. In many studies, kojic acid combinations with other topical agents are proved equally effective with a reduction of pigmentation in 52% of the patients. However, the adverse ffects can cause contact dermatitis
and erythema.

4) Retinoids

Retinoids in the form of retinoic acid can be used in the treatement of melasma. The acid, compared to hydroquinone, takes a much longer time to act evidently after 24 weeks.

Retinoids has produced a good therapeutic response in clinical trials but better results are obtained in combination with hydroquinone and corticosteroids. Also be aware of side effects such as erythema, burning, stinging, dryness, and scaling or hyperpigmentation in people with dark skin. Patients therefore must be advised to use sunscreens during treatment with retinoids.

5) Topical steroids

Topical steroids are used in combination products for their synergistic effects and for the reduction of irritation from other products like tretinoin. Various combinations with hydroquinone and retinoic acid have given good cosmetic results in clinical trials. Adverse effects of topical steroids include irritation, rosacea-like dermatosis, atrophy, telangiectasia, and hypertrichosis. careprost eyelash serum

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