WHAT IS HYPERPIGMENTATION?

Hyperpigmentation is the darkening of any area of the skin, due to an increase of melanin, resulting from any cause.

WHAT IS MELASMA?

Melasma is hormone-dependent hyperpigmentation, presenting as dark, irregular patches commonly found on the upper cheek, nose, lips & forehead.

It is not a harmful disease, however it can severely affect a person’s cosmetic appearance.

Although it can affect anyone, it is most common in women, in particular pregnant women (chloasma), which it is often known as “the mask of pregnancy’. Over 70% of pregnant women suffer from this condition.

Causes of Melasma and Hyperpigmentation

There are several known triggers for melisma:

• Sun exposure – this is the most important avoidable risk factor.
• Pregnancy
• Hormone treatments, including oral contraceptive pills containing oestrogen and/or progesterone, hormone replacement, intrauterine devices and implants.
• A photo-toxic reaction to certain medications & allergic reactions.
• Melasma has been associated with hypothyroidism

(low levels of thyroid hormone)

• Genetic pre-disposition

Patterns of Melasma

Melasma presents as macules (freckle-like spots) and larger flat brown patches. There are several distinct patterns.

• Centro-facial pattern: forehead, cheeks, nose and upper lips
• Malar pattern: cheeks and nose
• Lateral cheek pattern
• Mandibular pattern: jawline
• Reddened or inflamed forms of melasma (also called erythrosis pigmentosa faciei)
• Poikiloderma of Civatte: reddened, photo-aging changes seen on the sides of the neck, mostly affecting patients older than 50 years
• Brachial type of melasma affecting shoulders and upper arms (also called acquired brachial cutaneous dyschromatosis).

Race & Melasma

Melasma is most common among pregnant women, especially those of Latin and Asian descents, Afro Caribbean, Afro American, Arabic and African Skins.

People with olive or darker skin, like Hispanic, Asian, and Middle Eastern individuals, have higher incidences of melasma.

What are the types of Melasma?

Four depths of Melanin are recognised:

• Epidermal: excessive Melanin in superficial layer of the skin, usually light brown with a discreet edge.
• Dermal: contain of melanophages (cells that ingest melanin) throughout the dermis. This can be blue grey in colour with a fuzzy, indiscreet edge. Demal pigmentation is very resistant to treatment.
• Mixed: This type is most common & includes includes both epidermal and dermal melasma.
• Unnamed type: found in dark-complexioned individuals, where excess melanocytes are present in the skin of dark-skinned individuals.

Symptoms:

Melasma does not cause any other symptoms beyond the cosmetic discolouration, called Hyperpigmentation.

It looks like light brown to dark brown patches with sharp discrete edges on both sides of the face, commonly found on the cheeks, bridge of nose, forehead and upper lip.

You can reduce hyperpigmentation by:

• Avoidance of sun and irritants
  Use of sunscreen is essential.
  A SPF 30 or higher should be selected, protecting against UVA and UVB rays from the sun.
  Sunscreen should be worn daily, whether or not it is sunny outside, indoors or outdoors.
• Using topical de-pigmenting agents, which are scientifically proven ingredients that slows down the production of melanin.
• Use of chemical peels or topical steroid creams(but damages skin in long term use).

Any facial cleansers, creams or make up, which irritate the skin should be stopped immediately, as this may worsen the melasma.

Does skin whitening work on dark skin?

Skin whitening is a safe way of lightening skin, if certain rules are followed and established harmful ingredients such as Hydroquinone and steroid creams are avoided. However, Lightenex Plus® is a safe and effective solution for dark skin as it is a combination of safe, effective, & scientifically proven ingredients for skin brightening.

When unsafe skin whitening products are used over long periods of time, they can have many adverse effects.

Skin bleaching creams often contain the dangerous and banned ingredient, hydroquinone.

These cause severe skin irritation and, in extreme cases, skin cancer and liver damage. When used over long periods of time, hydroquinone can have several neurological effects such as tinnitus, headaches, nausea and dizziness. Hydroquinone has been banned in the EU since 2001 due to its harmful and dangerous properties.

Skin bleaching creams also often contain corticosteroids, when used for long periods of time can often lead to hormone imbalance which causes:

• Thinning blood
• Excessive bruising
• Skin irregularities
• Weight gain
• Reproductive problems

Often skin bleaching badly burns and damages the skin, sometimes to an extent where it cannot be repaired.

Lightenex® Plus by PharmaClinix® is the safest and completely natural alternative to these and it is specifically developed for darker skin. It is effective, quick, easy and most importantly completely safe.

GUIDELINES ON THE CHOICE OF SKIN WHITENING CREAMS

1. SUNBLOCKEX SPF50 IS MANDATORY TWICE DAILY.

2. Lightenex® Cream: Long Term maintenance of SKIN COLOUR in dry sensitive skins. Apply twice daily.

3. Lightenex® Gold cream: First line Day cream used twice daily to treat resistant Hyperpigmentation.

4. Lightenex® Gold Serum: Second line night serum FOR DEEP or HYPERKERATOTIC LESIONS to be massaged into the Hyper-pigmented patch of skin only.

For the face, massage into skin on alternate nights, increasing frequency by one night per week.

It can be used if Resistant pigmentation exists over the Flexures ie Knees, elbows, dark thick neck regions (Acanthosis Nigricans) etc. as a nightly serum with occlusion using Cling film.

5. Lightenex® Plus: This is rough equivalent to 4% Hydroquinone, with SPF 15 only. This can be used twice daily for long term  maintenance and in pregnant ladies.

6.Lightenex® Body Lotion (with SPF 15): Contains 36% whiteners and perfect for skin Lightening on the torso  or Sensitive skin.(i.e. Axillae, perineum & inner thighs.) It is non-irritating as it doesn’t contains acids.

(Hydroquinone is banned in Europe), due to its side effects.