There has been a lot of hype recently regarding treatments for melasma. Melasma, which is hormonally driven and affects women substantially more than men, appears as pigmented “islands” on the face. Lesions look typically like larger brown flat freckles, tend to be symmetrical, and often affect the cheeks, forehead and the “moustache” area. It has been called “pregnancy mask” when it develops in and around the time of pregnancy, but can be prompted by any hormone fluctuation including taking the birth control pill.
Although melasma is caused due to changes in hormones for some patients, exposure to sun, tanning salons or heat will exacerbate the condition. Proper sun protection and avoiding overheating may help to prevent the melasma from becoming more intense, but often will not fade entirely what has already surfaced. Patients often find, however, that the melasma is lighter in the winter due to being less exposed to sunlight.
I first heard of Tranexamic acid a few years ago when SkinCeuticals decided to create a pigment lightening serum that could rival the effects of Hydroquinone (HQ). They developed Discolouration Defense, with 3% tranexamic acid, kojic acid and niacinamide, a combination that could equal the reduction of pigment associated with HQ. And it absolutely does work!
But, for some patients melasma is very deep and very stubborn. Some melasma forms in the epidermis, or top layer of the skin. For many though, it forms in the dermis, the underlying layers, which are much harder to treat. In others, it affects both the epidermis and dermis.
Recent medical case studies have shown that applying 4mg tranexamic acid during microneedling is as effective as 4% HQ (which is no longer available OTC in Canada). Medical grade Vitamin C was also used in a split side comparison study done with 30 women and, although reduction was evident in both sides, the side with tranexamic acid had superior results.
It has been suggested to treat a minimum of 3-6 times, with a 1 month window between treatments. Patients will see some results in as little as 4-8 weeks, but additional treatments can continue to improve as a plateau was not recorded during the studies provided.
What does all of this mean? Well, when it comes to microneedling there are multiple ways to achieve results with different conditions or skin concerns. Regular microneedling can get a boost from PRP (platelet-rich plasma), RF (radiofrequency) and the addition of Vitamin C or Tranexamic acid.
What this also means is that there is a new hope when dealing with melasma. We know that melasma can be chronic in many cases, but if we can find ways that reduce the melasma or even make it go away at times, then the quality of life is much more pleasant for the patient. Melasma can make a patient feel insecure. It looks “dirty” and sometimes even the most intense make up can’t cover it.
With these current medical studies in mind, we have been sourcing out the best quality tranexamic acid to begin treating our melasma patients with microneedling. For at home use, the Discolouration Defense is a perfect pairing to our clinic treatments. Other good treatment options for melasma include: chemical peels, dermamelan, silkpeel microdermabrasion, and the at home treatments Lytera 2.0 and ZO Pigment Control.
Heads up melasma patients!! This new addition with microneedling may be the best new thing on the market for your concerns. And here at TDC, we will be offering our version in the very near future! Get a head start with the Discolouration Defense now. It can be found in our Cosmetics Clinic or at our online e-boutique.
~ Sheri Roselle, Medical Esthetician at Toronto Dermatology Centre
