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Posted September 01, 2011 in Uncategorized

At Concannon Plastic Surgery and Spa, we frequently see women who are dealing with hyperpigmentation of the face.  These darker areas of skin can be caused by sun damage, hormone fluctuations, or even remnants from acne lesions (post-inflammatory hyperpigmentation, or PIH).  All types of hyperpigmentation can be frustrating for the sufferer, but potentially the most difficult type of hyperpigmentation to treat is melasma.
Melasma, also known as chloasma or the mask of pregnancy, typically produces irregular, patchy areas of dark color.  Melasma is frequently described as having “lacy edges.”  Although it can affect anyone, melasma is particularly common in women, and is mainly associated with hormonal changes, such as changes that occur in pregnant women and those who are taking oral contraceptives or hormone replacement therapy (HRT) medications.  However, melasma even occurs in women who have never been pregnant and are not taking oral contraceptives.  In these cases, melasma may be due to a hormonal imbalance.  In either of these scenarios, sun exposure does appear to be a triggering factor in predisposed individuals.
Effectively treating melasma requires a multi-faceted approach as well as the dedication of both patient and skin therapist.  Due to the fact that melasma occasionally returns despite treatment, it is important to continue to follow your skin therapist’s recommendations in order to achieve long-term success.
  • The best way to prevent melasma is to limit your exposure to sunlight and regularly apply a sunscreen with an SPF of least a 30.  We have had great success with Obagi Sun Shield SPF 50, a combination chemical/mineral sunscreen.  Another excellent option is ColoreScience Sunforgettable SPF 50, a powder mineral sunscreen that has a light tint to even out skin tone as well as protect.
  • Hydroquinone can help fade existing melasma and help prevent the formation of new areas of hyperpigmentation. In order to be effective, a prescription formulation of hydroquinone 4% is typically indicated. Our patients have also had gratifying results with Obagi Nu-Derm, a prescription line of products designed to target all different types of hyperpigmentation (including melasma), as well as fine lines and wrinkles, skin laxity, and even acne.
  • Tretinoin (i.e. Retin-A), is a prescription-grade treatment cream that works best when paired with 4% hydroquinone to treat melasma.  It increases the turnover of skin cells, a process that helps reduce excess pigmentation.  In addition, tretinoin is the gold standard for topical anti-aging and topical anti-acne treatment.  At Concannon Plastic Surgery, we carry three different Tretinoin strengths:  0.025%, 0.05%, and 0.1%.
  • IPL (Intense Pulsed Light) or Photorejuvenation, is a treatment performed in a medical office.  The pulses of light are applied to the skin with a handpiece, resulting in the pigmented lesions initially darkening, and then sloughing off and new collagen fibers being laid down, giving the skin a renewed and more youthful (and lighter) appearance.  We are proud to offer our patients what we consider to be the best in Photorejuvenation:  the Lumenis ONE Photorejuvenation.  For more information on how we can treat your hyperpigmentation as well as broken capillaries and/or Rosacea with the Lumenis ONE, click here
  • Chemical peels can also be an effective tool in the fight against melasma.  Although peels vary greatly in their depth of exfoliation and effectiveness against hyperpigmentation, the new Concannon Signature Peels offer a variety of customizable strengths for every skin type and concern (and budget!).
For more information on any of the above products or treatments, please contact Concannon Plastic Surgery at (573)449-5000 and  We offer complimentary consultations with our experienced nurses and medical aestheticians.  Come experience our world-class approach to local skincare for yourself!