Dr Parushinee Naidoo is a medical doctor with a passion for aesthetics and has a clinic in Durban. She recommends the following preventative measures:
For melasma:
- The most effective way to prevent melasma it to use sunscreen. Effective sunscreen use will help prevent darkening and the spread of hyperpigmentation.
- Sun protection should also include wide-brimmed hats, UV protective fabrics, and sunglasses.
- Limit sun exposure during peak hours.
- Avoid irritating soaps, lotions, and over-exfoliation.
- If you are susceptible to melasma, reconsider hormonal birth control. Discuss other contraceptive options with your doctor.
For post-inflammatory hyperpigmentation:
- Actively managing the cause of the inflammation will help to reduce the risk of pigmentation.
- Use regular sunscreen as the hyperpigmentation darkens with sun exposure.
For both conditions, sunscreen is most effective, but rather use a sunscreen you are comfortable with than using no sunscreen at all. Use a minimum SPF 30+, but Dr Naidoo recommends SPF 50+, reapplied every two hours, as well as after exercising and swimming. The equivalent of half a teaspoon to the face and neck should suffice.
Treatment options
“The goal of treatment is usually to prevent further spread and darkening of the pigmentation, and then to lighten the existing pigmentation,” says Dr Naidoo, who believes that a combination of suitable homecare and skin treatments can achieve this. Home skincare includes sunscreen and using products which contain ingredients such as retinol, vitamin C and niacinamide, to name a few. “However, it is advisable to obtain professional advice on the appropriate skincare,” adds Dr Naidoo.
Chemical peels are a common form of treatment, and extensive studies have shown that if the patient’s skin is adequately prepared and the correct peel is selected, effective results are attainable. Dr Naidoo is quick to caution: “A patient’s skin needs to be adequately assessed prior to determining the suitable type of peel – superficial, medium depth or deep peel – and a course of peels is generally required. For those with melasma, this condition can rarely be cured, but with appropriate treatments and homecare, it may be successfully lightened and maintained.”
Micro-needling and laser therapies are also treatment options, but with all treatments, care must be taken when treating darker skin types to minimise the risk of worsening pigmentation. And lastly, always seek advice from a professional who is experienced in managing your specific skin type.
Zandri's story
Zandri, 36, who loves the outdoors, and enjoys scuba diving, swimming and running, shares her story:
“When I first noticed melasma in my mid-20s I was devastated, and felt robbed of my confidence and insecure. I had melasma so badly above my lip and I felt very 'unfeminine'. I bought (and wasted) so much money on products that promised to lighten it – but without success.
“My dermatologist suggested I do an IPL laser treatment, which was super painful and left scabs all over my face. This was unsightly, and once the scabs came off I was melasma free – but a few weeks later it came back, and worse than before.
“I had been on a contraceptive pill from the age of 18 for hormonal reasons, but after 11 years and in consultation with my dermatologist, I went off the pill, as I was advised that it could make it worse or impossible to get rid of. Slowly my melasma faded and I can now say I am almost completely melasma free,” says Zandri.
“I did try a few over-the-counter treatments prescribed by my dermatologist, but they made me even more sensitive to light and I didn’t like the side effects. Also, deep down I knew I had to fix the problem from the inside. I started taking MSM tablets which I also believe helped a little, and had a few facial peels which improved my melasma slightly. However, the only thing that took it away was stopping the oral contraceptive pill.”
Zandri’s tips
- Start your daily routine with a good sunscreen lotion.
- Don’t think the SPF in foundation is enough – it isn’t.
- I was severely deficient in vitamin D and started taking supplements, which seemed to help.
Zandri’s tips:
1. Bioderma Photoderm Max Aquafluide SPF50+ Light Tint definitely helped “smooth” the appearance of my melasma when I applied it after swimming or first thing in the mornings.
2. ISDIN Fotoprotector UV Mineral Brush SPF50+ is an amazing way to retouch your sunscreen (over your make-up) with its brush.
3. Revlon PhotoReady Primer Plus Makeup & Skincare has vitamin C in it which doctors say helps with melasma.