It's a common problem many women (and men) battle everyday - melasma. These brown patches usually show up on the forehead, cheeks, upper lip, and chin area. Women tend to be affected more often than men. No one knows exactly what causes it, but we do know that there are certain factors that seem to trigger the increase in pigmentation. Sun exposure and estrogen are the two biggies. Birth control pills, hormone replacement therapy, and pregnancy (in which case it is called chloasma, or the mask of pregnancy) rev up melanocytes to produce more melanin, which is responsible for pigment in the skin.
Melasma is a difficult condition to treat. Like many other conditions in dermatology (psoriasis, eczema, acne) there is no cure. A combination of topical medications and procedures are used to improve it, but results need to be maintained. The single most important factor is sun exposure. People with melasma MUST protect their skin from the sun. Sun avoidance, suncreen, sun protective clothing: the whole nine yards.
The gold standard in topical treatments is the lightening cream hydroquinone. This can be prescribed by a dermatologist and should be used under their supervision. A very rare complication of this cream is a condition called ochronosis, which results in darkening of the skin. Fortunately, this is not common. There are many other topical treatments available that do not contain hydroquinone. These are often used as well to treat melasma. These creams contain lightening ingredients such as azaleic acid, kojic acid, licorice, lignin peroxidase, etc. One of my favorite non-hydroquinone containing creams is Elure. It contains lignin peroxidase, a natural extract derived from a tree fungus. Retinoids can help lighten dark spots as well. If the treatments are irritating, a topical cortisone is sometimes used.
In addition to topical treatments, light chemical peels can be performed in the doctor's office. However, care must be taken to avoid hyperpigmentation (darkening of areas). The Fraxel Dual Re:Store has been shown to be very effective for brown spots on the face and can improve melasma.
Just as exercise and diet are used to help maintain a healthy weight, strict sun protection and various dermatologist-prescribed treatments can help maintain skin.
Thursday, April 5, 2012
Monday, April 2, 2012
What's New
I recently attended the annual American Academy of Dermatology meeting in San Diego. About 10,000 dermatologists from around the world attended the meeting, where the newest technologies in dermatology were presented. I love these meetings: not only do I get to see old friends, but I stay up to date on the latest and greatest in my field. So what's new on the horizon?
New injectables:
You've probably heard of facial contouring with fat, as well as injectables like Restylane, Juvederm, Radiesse, and Sculptra. Well, now there's a new player on the field - and it's completely unique. Laviv (azficel-T) is the first and only FDA-approved therapy that uses your own collagen-producing cells (fibroblasts) to improve the look of smile lines. How does it work? The dermatologist takes three small samples of skin from behind the ear. The skin samples are then sent to a laboratory, where fibroblast cells (cells that make collagen in the skin) are expanded to create your Laviv. Three months later, it is sent back to the dermatologist, who injects Laviv over three treatment sessions. South Beach Dermatology is a Laviv certified facility. Check out http://www.mylaviv.com/getting-laviv.aspx for more info.
New fat fighting treatment:
It's an age old battle: man (woman) versus fat. There's liposuction, laser-assisted liposuction, cryolipolysis (using cold to destroy fat), and now: Liposonix. Liposonix is a non-surgical, non-invasive treatment that uses high frequency focused ultrasound (HIFU) to destory fat cells. There are no incisions or needles. It's performed in the office as a one hour treatment to the abdomen and love handles. Results typically take about 8-12 weeks, and on average, an one inch reduction is seen from the waist area. Liposonix will be available at Horwitz Dermatology next month. Check out http://www.liposonix.com/ for more info.
New product:
CeraVe SA Renewing Lotion combines the great moisturizing (ceramides, hyaluronic acid) power of CeraVe with salicylic acid. It's great for keratosis pilaris: those rough bumps on the back of the arms. Dry, thick, cracked heels? Try this out!
I love sharing the newest treatments in derm with all of you. Stay tuned for more!
New injectables:
You've probably heard of facial contouring with fat, as well as injectables like Restylane, Juvederm, Radiesse, and Sculptra. Well, now there's a new player on the field - and it's completely unique. Laviv (azficel-T) is the first and only FDA-approved therapy that uses your own collagen-producing cells (fibroblasts) to improve the look of smile lines. How does it work? The dermatologist takes three small samples of skin from behind the ear. The skin samples are then sent to a laboratory, where fibroblast cells (cells that make collagen in the skin) are expanded to create your Laviv. Three months later, it is sent back to the dermatologist, who injects Laviv over three treatment sessions. South Beach Dermatology is a Laviv certified facility. Check out http://www.mylaviv.com/getting-laviv.aspx for more info.
New fat fighting treatment:
It's an age old battle: man (woman) versus fat. There's liposuction, laser-assisted liposuction, cryolipolysis (using cold to destroy fat), and now: Liposonix. Liposonix is a non-surgical, non-invasive treatment that uses high frequency focused ultrasound (HIFU) to destory fat cells. There are no incisions or needles. It's performed in the office as a one hour treatment to the abdomen and love handles. Results typically take about 8-12 weeks, and on average, an one inch reduction is seen from the waist area. Liposonix will be available at Horwitz Dermatology next month. Check out http://www.liposonix.com/ for more info.
New product:
CeraVe SA Renewing Lotion combines the great moisturizing (ceramides, hyaluronic acid) power of CeraVe with salicylic acid. It's great for keratosis pilaris: those rough bumps on the back of the arms. Dry, thick, cracked heels? Try this out!
I love sharing the newest treatments in derm with all of you. Stay tuned for more!
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