Melasma Treatment

Melasma
Treatment
Melasma can be difficult to treat. The pigment of melasma develops gradually and is still dradata resolution. Resistant cases of recurrence are common and occur when sun avoidance is not maintained. All the wavelengths of solar radiation, including those of the visible spectrum are capable of inducing melasma.
Rapid methods such as cryotherapy, chemical peeligurile deep lasers have poor outcomes and are associated with a number of adverse effects, including epidermal necrosis, hypertrophic scars and hyperpigmentation postinflamatorie. Precise manner in which these methods can be used has not been specifically studied. Still, experienced physicians can be safe and effective and produces results faster than those topics.
In an attempt to hasten the resolution of many practitioners try peeling easier with superficial chemical peels. The reasoning is this: if melanogenesis is inhibited by the bleaching agents and keratinocyte turnover is high time resolution can be lowered. A number of studies show that treating melasma with chemical peels and depigmentation agent is safe and effective.
Topical agents remain the standard treatment of depigmentation. Hidroquinona is most often used. It is a chemical that inhibits tyrosinase hidroxifenolic leading to decreased production of melanin. Can be applied as a cream or alcohol solution. Concentration ranges from 2% to 4%. Effectiveness is directly related to concentration but is also no adverse efctelor incidence increased with concentration. All concentrations lead to skin irritation, phototoxic reactions with secondary postinflamatorie hyperpigmentation and exogenously ocronosis irreversible long-term use of concentrations of 2%.
Tretinoin can be effective as monotherapy. However, treatment response is weaker and slower compared hidroquinona. Amelioraea require six months or more. It is believed that tretinoin acts by increasing keratinocyte turnover and limiting melanosomi transfer in keratinocytes. Major side effect is skin irritation, especially in high concentrations. Temporary photosensitivity and hyperpigmentation may appear paradoxical.
Azelaic acid cream is available in 20% formula. The mechanism of action is not fully understood. DNA synthesis is reduced and cellular mitochondrial energy production is inhibited in melanocytes. Girl hidroquinona azelaic acid seems to target only hyperactive melanocytes and normal skin will not whiten. Primary side effect is skin irritation. No phototoxic or photoallergic reactions. Other depigmentation agents used are 4-N-butilresorcinol, phenolic-thio, 4-isopropilcatecol, Kojic acid and ascorbic acid.
All treatments presented will fail if they continue to sun exposure. Prudent measures to avoid include hats and sun cream to apply broad spectrum SPF protection daily. Creams that contain physical blockers like titanium dioxide or zinc oxide are preferred over chemical blockers because of the broad protection. UV-A, UV-B and visible light are all capable of stimulating melanogenesis.
Prognosis. Melasma Treatment Skin pigment may require a longer time to deliver because no effective therapy can not remove skin pigment. However, treatment should not be stopped mainly due to skin pigment. Source is the epidermis and dermal pigment if epidermal melanogenesis may be inhibited for long periods will not redepozita skin pigment and can be solved slowly. Resistant cases of recurrence occur frequently and are safe if not strictly broken sunlight. 
Melasma Treatment