Managing Melasma In Darker Skin Tones

Managing Melasma In Darker Skin Tones

Melasma is a type of hyperpigmentation that can affect the face, neck, shoulders, and decolletage. It is often mistaken for age spots, but it’s caused by excessive melanin, which causes the skin to become uneven in tone. In this article, we’re going to look at treatment creams and serums designed to treat this condition. But first, let’s look at what exactly causes melasma

What Causes Melasma?

Melasma is a dark pigmentation of the skin which typically affects women during pregnancy or menopause. It is caused by hormonal fluctuations (including from hormonal treatments) or pregnancy, sun exposure, and genetic predisposition. For those who suffer from melasma (a condition that occurs when the pigment cells of the epidermis change and create patches of discolouration on the skin), it can be difficult to find treatment options. 

People with darker skin tones are more susceptible to pigmentation problems, where minor skin injuries like insect bites, can cause a change in skin pigment, creating dark spots called hyperpigmentation. The symptoms of melasma can differ depending on a person’s skin tone with melasma on dark skin appearing as dark brown or grey-brown patches. These patches often appear in asymmetrical patterns on both sides of the face or other parts of the body:

Brachial: Appearing on the shoulders and upper arms.

Centrofacial: Appearing on the forehead, cheeks, nose, and upper lip.

Lateral cheek pattern: Appearing on both cheeks.

Malar: Appearing on your cheeks and nose.

Mandibular: Appearing on the jawline.

Neck: In people aged 50 or older, melasma can appear on all sides of the neck. 

There are melasma treatment creams that can help reduce signs of melasma that use any of the following ingredients: retinoids, hydroquinone, ketoconazole, Tazorac, tretinoin, azelaic acid.

Types of Melasma

There are three types of melasma, which correspond to the depth of the hyperpigmentation in the skin:

Epidermal: This presents as a dark brown colour, a well-defined border, appears obviously under black light and sometimes responds well to treatment.

Dermal: This type has a light brown or bluish colour, a hazy border, appears no differently under black light and doesn’t respond well to treatment.

Mixed melasma: This is the most common of the three, has both bluish and brown patches, shows a mixed pattern under black light, and shows some response to treatment.

Melasma Treatment For Darker Skin

Due to the complexity of its causes, melasma include brightening and fading creams and serums, hydroquinone, retinoids, and chemical peels. There are also a number of in-clinic therapies that have been shown to be safe and effective melasma treatments for darker skin tones. 

Prescription Only Creams & Serums: Today, there are more and more telemedicine providers creating personalised Melasma treatments for their patients based on their lifestyles, and current skincare routines. While you could continue to use over-the-counter (OTC) melasma creams, they will often contain the same ingredient mix, in the same proportions (NOT tailored to your specific needs), for most conditions. Everyone’s skin is different, which makes these OTC creams largely ineffective when it comes to fading the pigmentation that comes with melasma.  

With a personalised treatment cream blended specifically for your skin’s sensitivity and tolerance, you will see a marked improvement (usually between three to six months of continuous use of the treatment) in your pigmentation. Telemedicine services often begin with a questionnaire, followed by an online consultation with a doctor, who will then diagnose your melasma. A prescription-only cream base or serum is then formulated for your needs and delivered to your door.

These clinically compounded melasma creams will have a combination of the following ingredients, dependent on what other skin problems you might be addressing at the same time:

Azelaic Acid – The properties of azelaic acid are the reason it is so effective in helping to get rid of melasma. There are three main reasons why this acid is so effective in fighting this skin disease: it targets melanin, its anti-inflammatory properties reduce redness, and it has antioxidant properties that help fight free radicals.

Hydroquinone – Hydroquinone is a powerful ingredient that helps to fight against hyperpigmentation. It works by inhibiting tyrosinase, an enzyme involved in melanin formation. Hydroquinone is found in creams and lotions to combat the common skin condition melasma.

Tranexamic Acid – This acid, also known as TXA, is a chemical compound that has been shown to help with fading melasma. This is because TXA was found to inhibit the growth of melanin (the pigment responsible for producing skin discolouration). It also helps with inflammation and makes it easier for the other ingredients in the treatment to work.

Tretinoin – Tretinoin, a synthetic form of vitamin A, is one of the most popular medications prescribed to patients with melasma. This cream contains the active ingredient tretinoin, which is a retinoid that has anti-inflammatory properties. When combined with other important ingredients found in topical creams, it can help people get rid of dark spots and hyperpigmentation caused by melasma.

Retinol – Retinols targets a multitude of anti-ageing concerns, from skin tone to laxity and texture. Once you find the right retinoid for your skin type, it smooths fine lines and wrinkles, boosts collagen production, and helps banish hyperpigmentation

Microdermabrasion: A mildly abrasive instrument is used to remove the top layer of skin, often used for treating scarring, discolouration, sun damage, and stretch marks.

Microneedling: When treating melasma, microneedling is used in tandem with skin lightening creams containing a topical retinoid, vitamin C serums, or hydroquinone creams.

Medium-Depth Chemical Peel: Glycolic peels are commonly used to treat melasma. Azelaic acid reduces melasma in darker skin tones with its anti-melanin properties that act on hyperactive melanocytes.

Laser and Light Therapy: If you have dark skin, you should avoid Intense Pulsed Light (IPL) treatments, Fraxel lasers, skin-tightening lasers at the 1540 wavelength, and laser hair removal. These treatments cause trauma to the skin, which for darker tones can often result in post-inflammatory pigmentation. 

With all of this in mind – while it can take time to see results from these treatments, we wish there was a magical cream – if it makes you feel more confident it is definitely worth investing in your skin.

Understanding Traditional Chinese Medicine

Understanding Traditional Chinese Medicine

Chinese traditional medicine, also known as traditional Chinese medicine (TCM), is a broad range of medicine practices sharing common concepts which have been developed in China and are based on a tradition of more than 2,000 years ago, including various forms of herbal medicine, acupuncture, massage, exercise, and dietary therapy. It is formed by summarizing the precious experience of understanding life, maintaining health, and fighting diseases accumulated in daily life.

In TCM practitioners use herbal medicines and various mind and body practices to treat or prevent health problems. Today Chinese traditional Medicine continues to develop and is used by millions of people around the world.

Chinese Traditional Medicine Theory

It helps to understand that Chinese medicine is a practical system of medicine that grew out of empirical traditions and thousands of years of observed outcomes.

TCM is based around 4 ancient belief systems:

  1. The human body is a miniature version of the larger, surrounding universe.
  2. Harmony between two opposing yet complementary forces, called yin and yang, supports health, and disease results from an imbalance between these forces.
  3. Five elements—fire, earth, wood, metal, and water—symbolically represent all phenomena, including the stages of human life, and explain the functioning of the body and how it changes during disease.
  4. Qi, a vital energy that flows through the body, performs multiple functions in maintaining health.

There are several forms of Chinese Medicine practiced; the most common are:

  • Herbal Medicine – Chinese herbal medicine is the practice of combining individual herbs into formulas to promote health benefits. Herbs are carefully selected, processed, and dried. They are given to a patient in a tea or pill, or in the form of pharmaceutical grade extracts—the growing choice for most patients and practitioners.
  • Acupuncture – Acupuncture entails stimulating certain points on the body, usually with a needle penetrating the skin, to alleviate pain or to help treat various health conditions. The general theory is based on the premise that there are patterns of energy flow (Qi) through the body that are essential for health. Disruptions of this flow are believed to be responsible for disease.
  • Cupping – In cupping a therapist puts special cups on your skin for a few minutes to create suction. People get it for many purposes, including helping with pain, inflammation, blood flow, relaxation and well-being, and as a type of deep-tissue massage.
  • Scraping – Scraping, or “Gua Sha”, uses pieces of smooth jade, bone, animal tusks, horns, or smooth stones to scrape along the skin to release obstruction and toxins that are trapped at the surface of the skin. The scraping is done until red spots then bruising cover the treatment area.
  • Tai chi – Tai chi is a centuries-old mind and body practice. It involves gentle, dance-like body movements with mental focus, breathing, and relaxation. It has evolved over centuries to become a means of alleviating stress and anxiety, a form of “meditation in motion.”
  • Qigong – Qigong encompasses physical postures, breathing techniques and focused intention. The word Qigong (Chi Kung) is made up of two Chinese words. Qi is pronounced “chee” and is usually translated to mean the life force or vital-energy that flows through all things in the universe.


Is Chinese medicine safe?

Yes, most forms are considered safe. However, herbal medicines used in TCM are not exactly regulated like western medicine. Many of the herbal products are available online and marketed as dietary supplements. Some Chinese herbal products are safe, but others may not be. Therefore, it is vital to ensure you receive your Chinese herbal medicine from a certified Chinese medicine doctor or supplier.



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