Popularly also known as a pregnancy mask. But does this term still fit this skin condition? New research has examined the cause and approach of melasma.
And now for the new studies! So far, it has been assumed that hormones alone were the reason for the creation of the “pregnancy mask”. An additional factor, which had never been included before, is the fact that women in the last stages of pregnancy spend relatively more free time outside, in the sun. An extra 10 hours a week outdoors increases the risk of melasma developing during pregnancy by as much as 27%.
Melasma is not only related to our melanocytes (pigment cells), because other cells (keratinocytes, fibroblasts, mast cells, endothelial cells and possibly sebocytes) also play a role.
The complex disorder involves several pathomechanisms:
If we take the above into account and now look at the pathomechanisms associated with “photo-aging” (skin aging due to chronic sun exposure). We then see the same list of pathological symptoms, namely an increased number of dermal mast cells, solar elastosis, an altered basement membrane and increased vascularization.
New studies thus show that melasma is perhaps best treated by approaching it as a photo-aging disorder. This means that more cells in the skin need to be taken into account, instead of just looking at melanocytes. These cells need to communicate with each other in a healthy way again.
A double-blind placebo-controlled study showed that Polypodium leucotomos (abbreviated PLE) is a valuable addition to a standard treatment for melasma. For years, it has been known that PLE acts as a powerful antioxidant against sunburn. The beneficial effect of melasma is not yet easy to explain. It is likely to make the skin more resistant to the adverse pigment stimulation caused by the sun's ultraviolet B (UV-B) rays.
Melasma has been and remains a persistent and challenging condition to treat. The process consists of multiple treatments and the recurrence rate is high. For this reason, intensive and long-term sun protection remains the absolute building block of the treatment. A sunscreen must provide broad spectrum protection against UVA and Visible Light (HEV) and contain a high sun protection factor (SPF).
In addition, several studies show that combination therapies, such as microneedling with tranexamine acid or peels, with topical hydroquinone and polypodium leucotomos (PLE) are most effective.
For the best advice and the right approach to photo-aging/melasma, you can go for an informal consultation.
