Last weekend, Great Earth Pharmacy joined experts in the field of anti-aging, cosmetic dermatology and plastic surgery at the Plastic Surgery Symposium in Long Beach, CA. Experts included Dr Tanya Kormeili, a board-certified dermatologist serving Santa Monica and Manhattan Beach and Clinical Professor of Dermatology at UCLA’s David Geffen School of Medicine. Here is an exclusive peak.

Prevalence and Causes of Melasma (dark spots)

Dr Kormeili’s engaging presentation focused on the topic of melisma (dark pigmented spots of the skin). Melasma is one of the most common pigmentary disorders patients present with at dermatology clinics. According to the American Academy of Dermatology, “People with darker skin, such as those of Latin/Hispanic, North African, African-American, Asian, Indian, Middle Eastern, and Mediterranean descent are more likely to get melasma”. The precise cause of melasma (dark spots) remains unknown; however, there are many possible contributing factors. One such factor is hormonal changes. According to AAD website, melasma or dark spots frequently appears in pregnancy. “When melasma appears in pregnant women, it is called chloasma, or the mask of pregnancy. Birth control pills and hormone replacement medicine also can trigger melasma”.

According to a 2006 study in the International Journal of Dermatology, 11.3% of the patients declared that they have developed melasma after using OCP Oral Contraception. Another 14.5% developed melisma during pregnancy, 9.8% sun exposure, 4.9% liver disorders, 4.9% nutrition and 1.6% sex of newborn.

How do dermatologists treat melasma?

A dermatologist may recommend a topical medication to help alleviate your melasma. Such medications include:

Hydroquinone: This medicine is a common first treatment for melasma. It is applied to the skin and works by lightening the skin.

Tretinoin and corticosteroids: To enhance skin lightening, your dermatologist may prescribe a second medicine. This medicine may be tretinoin or a corticosteroid. A compounding pharmacy can combine 3 medications (hydroquinone, tretinoin, and a corticosteroid) into 1 cream. This is often called a triple cream or triple bleach.

Other topical (applied to the skin) medicines: Dermatologists may also recommend a combination of azelaic acid, kojic acid, ascorbic acid to help lighten melasma.

2013 study in the Indian Journal of Dermatology found that “kojic acid in synergy with hydroquinone is a superior depigmenting agent as compared with other combinations”.

Dr Kormeili also provided these great tips for caring for melasma.

  • Sun protection. SPF apply and reapply.
  • Laser treatments. Some patients are not good candidates and can get worse melasma relapse after few months of treatment with lasers.
  • Various chemical peels of different chemicals and percentages can help fade away melasma and restore the glow of the skin.

Dr Kormeili also educated the audience on the importance of getting regular skin cancer screenings by a board certified dermatologist as skin cancer may appear like melasma to an untrained eye.