Chloasma

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What is chloasma?


Chloasma is a term used to describe a pattern of pigmentation of the face affecting the cheeks and sometimes the nose, forehead and upper lips.  It is also called Melasma.


What is the cause of Chloasma?


The cause of Chloasma is unknown. However, there are some known trigger factors.

Pregnancy

Oral contraceptives

Hysterectomy

Ligation

Sunlight


It is thought that the hormone Oestrogen is responsible for the production of Chloasma.

No matter what the trigger factor is, one central underlying factor is the exposure to sunlight.


What can be done for Chloasma?


Chloasma is at best difficult to treat. In the past several remedies with various success have been tried. The include:


Hydroquinone

Skinoren

Retin A

Kojic Acid

Thiolin


These have all worked to a certain degree but not consistently enough to be regarded at the treatments of choice.


How is hydroquinone used?


If hydroquinone is prescribed, it should be used for a maximum of three months.  Thereafter, its use should be discontinued or reduced.   Prolonged use of hydroquinone could cause a peculiar pattern of darkening of the skin called Ochronosis.  The higher the concentration of hydroquinone and the longer its use, the greater is the likelihood of development of ochronosis. 


Sunblock should always be used with hydroquinone containing products.


Apply the cream to the affected areas at night only. If you see a response within three months, you will be allowed to continue cautious use of the product on an intermittent basis. However, if no response is seen within three months, further use should be discontinued. It is advisable to use the cream  with its own Cleanser and Sunblock, available from your dermatologist.   The use of the Hydroquinone, Cleanser and Sunblock constitutes the home care range.


New treatment for Chloasma


Pigment lightening cream from the cosmecuetical house Neostrata is now also available.  This is a non hydroquinone product and is applied twice a day.  Its main ingredients are kojic acid and alphahydroxyacid.  It is used as a safer substitute for hydroquinone and there is no limit to the amount of time it can be applied.


How is microdermabrasion performed


Microdermabrasion is a novel treatment for the lightening of Chloasma.  It utilises Aluminium Oxide Crystals (Corundum) which is the second hardest known substance after diamond.  This is applied under pressure to the skin.  The treatment is combined with lightening agents such as hydroquinone and Kojic acid.  One treatment a month is recommended for a period of 8 months.


How long does it take to see a result?


Usually, anything from three to six months, depending on the number of sessions performed.


Are there any side effects?


Some discomfort  may be experienced during the procedure.  However, it is usually well tolerated.