On March 29, 2012 by constance

There can be no more frustrating a skin complaint than battling with pigmentation. I’ve found in my many years of clinical practice that knowing what kind of pigmentation one is dealing with is crucial to successful management and results.

W H A T  –  I S  –  M E L A S M A

Pigmentation is a discoloration of the skin that can plague women and men of all ages. Hyperpigmentation is caused by sun damage or irritation and inflammation to the skin. It can be resolved with a good skin health restoration plan, using the correct treatments, ingredients and products. Six to sixteen weeks is the time that we allow in our practices at Plastic Surgery Associates and at The London Wellness Centre for a full face to be resolved.

Melasma is a discoloration of the skin seen only in women that is caused by hormonal disruption or imbalance and further aggravated by exposure to the sun.  Most people don’t know how to deal with it and spend a fortune on skin lighters and brighteners. They also spend a hefty sum on treatments that do not work. After thirty years in the advanced beauty and wellness arenas, I have witnessed patients and clients who have recounted the small fortunes they have spent having procedures from microdermabrasion, laser treatments, IPL, Fraxel, Thermage to eradicate the condition. None of them worked and all drove more inflammation into the skin.

The main reason, those devices do not work is the tendency of non-specialists to rely on the “magic wand” in a cavalier have a go fashion of the untrained. A laser or device will never change the physiology of a skin cell. The right ingredients in a product or topical treatment can. For that reason, I am passionate about educating beauty therapists to get their hands on those faces. Knowledge for the client and therapist however is key.

T  H E  –  C A U S E S  –  A N D  –  T R E A T M E N T

With the numbers of cases growing due to a rise in the numbers of women who are taking birth control pills, having IVF or dealing with stress and the subsequent knock-on effects of the peri-menopause, menopause and adrenal fatigue, cases of Melasma are on the rise. A thorough knowledge of the pertinent facts about what causes it, as well as what works is crucial therefore in preparing for the skin and beauty treatment arsenal.

Knowledge is key, so let’s start there first. Here is a list of the evidenced based information we give our patients and clients at our practices.

There is a link between silent internal inflammation and Melasma, so understanding the lifestyle elements such as good nutrition and a healthy approach to drinking is crucial.

The yeast-candida connection involved in Melasma is important to check and to treat.

If you are experiencing Melasma, you may be Vitamin D deficient, Omega 3 deficient and H-Pylori positive. You also need to increase your amino-acids.

It is very important not to use bog standard foundation make-up and to choose instead a good quality pure mineral make-up. Mineral powder make-up is not created equal, so 100% Pure Minerals is recommended. This tends to have less mica in the formulation and is a lot healthier for the skin, as pure minerals reduce the inflammation in the skin that drives Melasma deeper and deeper into the skin. I recommend Ultra Finish, Pur Minerals available from Medico Beauty Ltd.

Tyrosinaise, also known as monophenol monooxygenase is an enzyme that is associated with Melasma. It catalyzes the production of melanin and other pigments from tyrosine by oxidation, as in the blackening of a peeled or sliced potato exposed to air. It is found inside melanosomes. In humans, the tyrosinase- melanocyte over-activity which causes the skin to develop an over-production of melanin, which is the pigment that is released in the skin to protect it from attack. When there is hormonal disruption, over-production of the tyrosinase is the key feature which must be addressed.


The correct treatment must be associated with inhibiting the over-supply of the enzyme. Products such as ResultsRx  Lightening and CosMedix Lightening contain ingredients such as L-Arbutin, to regulate and assist in resolving this in the skin. Although Hydraquinoine is a prescription medicine, it is not advised either as a skin lightening agent or medication. “Years of use is sheer abuse” , is the golden mantra of those familiar with the china doll faces, like Michael Jackson’s who were prescribed this drug for years by their dermatologists in the USA. It is banned from products sold in the UK and most of Europe.

A good retinoid and a slew of antioxidants. I love L-Retinol AGP available in many advanced skincare products from leading aestheticians and med spas. Chiral L-Retinol AGP is available in Results Rx in the product A Solution, whilst Results Rx have a brilliant mix of the Retinol AGP and the Lightening in a very popular product which flies off my shelves, called Results Rx  X_Cellerate. This is a hero product in advanced skincare and one of my favourites in the treatment of pigmentation or Melasma as it gives the user the added benefits of an anti-ageing winning product  also.

CosMedix Define and CosMedix Refine are stronger strengths of the above. I also stand by the results available from the Osmosis range of treatments such as Quench and Stem Cells from Osmosis. Societe range has an amazing antioxidant and skin lightening products called Brightening Serum.


Pregnancy is the first hormonal disrupter likely to cause Melasma. The pregnancy mask will fade, but it is important to adhere to a sensible skin routine during pregnancy, so as not to exacerbate this condition.  As a midwife and medical aesthetic practitioner, I recommend that pregnant women use a gentle wash, an antioxidant serum and a natural physical sunblock such as those available from CosMedix. Aysha Awwad at Medico Beauty Ltd. speaks highly of AHA’s but like myself, is not a fan of glycolic acid, as the molecule is very small and can cause havoc in the skin of a pregnant mother.

G L Y C O L I C  –  A C I D 

Humans have no receptor sites for glycolic acid, whereas we do have a receptor site for lactic acid, as we make it ourselves in our skin. It is the precursor to our own collagen and as an AHA; lactic acid is a wonderful skin brightener, exfoliator and moisture boosting ingredient. In clinical studies, it does a good job in the therapists treasure chest of treatments and a really good med-facial always starts with a lactic acid wash. Medico Beauty’s Pure Enzymes is a brilliant Home Care treatment that boosts skin cell turnover and assists significantly in the gentlest therapeutic approach towards the successful treatment of Melasma. I get great results from their Pomegranate Infusion and also from their Chiral Benefit Peel.

Avoiding harsh exfoliation in the treatment of Melasma is crucial. So avoid harsh ingredients and most particularly peels unless they are specific and chirally corrected.

Dermal Infusion is now the first therapy of choice. A long list of available cheer-leaders is available from Medico Beauty.

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