what products would your recommend for at home care for Melasma?  Also professional products for her facial?  She does not have a bad case of it.

 

thanks for any insight

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First and foremost the melasma sufferer needs to apply sunscreen every day no matter what.  A physical block sunscreen containing titanium oxide and/or zinc oxide.  Also, what caused the melasma?  This can be a factor because if it is from being pregnant you can't stop that.  Birth control pills and too much sun is one cause.  Pregnancy another.  Then home care should include some type of peeling agent such as retinol/retinoids, mandelic acid, sal., glycolic, something, as well as, a bleaching agent like hydroquinone, mandelic, etc.  If the client is pregnant you need to be careful what you put them on for peeling and bleaching/lightening.  For treatments you can provide peels and/or microdermabrasion.  Lots of variables.  What is their fitzpatrick, are they outside a lot, are they pregnant, is it actually PIH, etc.  This is just some basic information on melasma.  I now see that you posted in Skin Script (my apologies for not seeing that).  You are probably better served by Lisa's response if you are utilizing those products.

Hi Angela:

Melasma is a tough one.  It's something you maintain as it can come and go based on sun exposure and hormonal fluxuations.

Homecare:  Green Tea (or Pomegranate) Cleanser as a daily/primary cleanser, Glycolic Cleanser and Retinol Scrub used 2-3 times per week to exfoliate dead skin, Glycolic/Retinol Pads are the number 1 skin lightening product.  Use these pads 2 times per day directly on the melasma.  I spot treat pigment with these.  I use Cucumber Toner on the rest of the face as to not overdry the skin.  Continue with Ageless Skin Hydrating Serum, Vitamin C (natural lightener), appropriate moisturizer and spf.

Professional:  If you want to do enzymes, use the Lemon Zest to lighten the skin.  Otherwise, I recommend the attached TCA peel protocol for melasma and pigmentation.  It's a total of 4 peels in 8 weeks and I have received some amazing results with that treatment series. 

Once you have completed the series, then we want to maintain that melasma.  After I reach my clinical end point, I see my client every 4 weeks (once a month).  One month I perform the Lemon Zest, then the next month, I perform a Lemon Zest, but end with 2 layers of TCA to keep the pigment away.


I realize this is a lot of information, but if you follow the attached TCA protocol, you'll achieve 50-75% lifting of melasma.  Let me know if you have questions.

Lisa

Attachments:

I am sure this is not the answer your looking for but melasma is hard to treat!! Laser treatments are the best bet.

oh - I am going to have to disagree with laser treatments.

I had two clients that were talked into that by derms (this was before I had seen either one)...both of them were happy with the results at first, And both ended up looking worse when the melasma returned.

One had been given an HQ Rx and had some problems with that too.

I think that their experience underscores the need for on-going treatment and homecare. This is what estheticians can do for their clients, manage and treat skin conditions, walk them through what they need to be doing at home and taking the time to make sure they know the importance of it.

Maybe not as fast or aggressive as laser - but often safer and in some cases more effective

For melasma, I have had (1) laser treatments, (2) medical-grade chemical peels, and (3) my light peels.  Initially, the laser will take the melasma away, but you are right, it comes back in full force.  The medical-grade chemical peel (Cosmelan) was the same; it went away but came back in full force.  Based on my research from medical conferences, light chemical peels are the way to go.  Just keep up with them on a regular basis (meaning perform a series, but then maintain every month or two), to keep the melasma at bay.  I don't want to start an argument on what treatments are best, but I am offering my personal opinion, experience in the med spa and research.

Hi Lisa How often would you go back to do a series of like lactic peels if after a 6 week series we still need to lift more pigment?   Should I wait a month say? and then would it help to alternate like a lactic one week and say a microderm. the next week? ( another 4-6wks. I can not do both in the same treatment in Wisconsin thanks 

Cheryl:  Are you able to start using the TCA for the pigment?  Or is she too sensitive?  I would start TCA peels every 3 weeks to help lift more pigment.  Otherwise, you are not limited to 6 peels.  Sometimes I do 12 or 18 weekly peels depending on the client's issues.  After 3 months of peels like this, I would discontinue for a couple of months before resuming.  Does that help? 

yes that helps. Thank you When I can use Skin Scripts I am following your protocols But when I have to use other lines as I work at another place they don't have a tca for us so I am limited to lactic,glycolic, salicylic. and microdermabrasion. Always learning :) thanks Lisa Hope to meet someday 

I used the TCA protocol for a melasma client (my first time ever working with melasma) and it completely got rid of it. In fact, I had the client pre pay (yay!) for the protocol and the melasma was gone before we even finished. Even her doctor was amazed. The doctor told her "Well, obviously your esthetician knows what she's doing so I would just keep doing what she tells you."

HA!!!

That is Awesome!! Keep up the good work Great testimonial!

Wow!!!!   I'm so glad your client received the results you were looking; this is what makes our careers so rewarding.

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