Poto, also commonly used to express Melasma in Nepali is a type of hyperpigmentation that causes dark patches on the face, particularly the bridge of the nose, cheeks, forehead, upper lip, and jawline. It affects women as well as men.
1. What are the known triggers for melasma?
The foremost factor is exposure to UV rays (invisible) and visible light, pregnancy, stress, birth control pills, medicines that cause sun sensitivity, products with fragrance such as essential oil, heat (infrared) and genetic predisposition.
2. Is melasma only a problem during pregnancy?
Not at all. Melasma is commonly seen in pregnant women so it is likely to be associated with pregnancy. It is not uncommon to have melasma a few months or years post-delivery. We have seen melasma equally prevalent in unmarried women and men as well.
3. How long can a melasma last?
Melasma is unpredictable. It may fade completely when the triggers are removed without treatment or while you wait for it to fade it may spread covering your face. Melasma can also last for years, or even a lifetime.
4. Is it necessary to do melasma treatment?
While melasma won't harm your body but it has psychological social impact. People with melasma feel less confident, and tend to avoid social interaction. Hence, understandable people with melasma want to treat it.
5. What must you do at home until you visit a dermatologist?
Sun protection: UV rays (invisible) and visible light can cause the skin to make more pigment which can darken existing pigmentation and cause new patches.
So, protect your skin from the sun all the time. Wear a wide-brimmed hat, mask, carry an umbrella or seek shade, and apply a broad-spectrum sunscreen (SPF 30 or higher) throughout the day. Look for sunscreen that has zinc oxide, titanium dioxide and iron oxide.
Antioxidant serum: You may layer different antioxidant serum such as vitamin C, niacinamide, coenzyme Q10 etc underneath your sunscreen. Antioxidant helps to curtail the damaging effect of free radicals that is being produced by rays, pollution, and stress
AHA Chemical peel: Chemical peel such as glycolic acid, mandelic acid, lactic acid etc helps by removing pigment laden cells. You may try home use chemical peel every 15days to 1month on a regular basis. Make sure the peel is not overtly burning or irritating your skin, otherwise it may do harm than benefitting you.
6. What you mustn't do at home?
You shouldn't do anything that irritates your skin such as applying lemon juice, bleaching products that has no proper label and ingredient list, or steroid based skin lightener.
7. Would you advise any natural home DIY?
One may feel good on trying different kitchenette stuff but it doesn't translate to visible changes that you would like to see. I don't have any DIYs to suggest simply because it is not effective.
8. Does any oral vitamin supplement or herbal concoction help in melasma?
We are consuming far more than required, and yet! it doesn't get delivered into the skin as much as we wanted. The care is rather out of it. So, it is all about using great quality antioxidant serum, sunscreen and safe skin lightener.
9. Why do some people with melasma have a flushed red face?
Market is flooded with skin lightening creams with tall claims, so people fall for it. The unregulated use of over-the-counter skin lightener can cause skin thinning which causes the blood vessels to become more apparent, intolerance to sun hence, they have flushed face in the background of pigmentation. In addition, these creams cause wrinkles, pimples, increase facial hair and paradoxical darkening of the skin.
10. Are lasers safe for melasma?
I wouldn't suggest any lasers for melasma as the chances of paradoxical darkening is higher than actual fading post laser. However, some dermatologists are comfortable doing lasers, and needling for melasma. So, it is all up to the treating dermatologist and the patient.
11. What is a chemical peel? And why is it done in melasma?
Chemical peel or Medi peel is a cocktail of ingredients that helps to exfoliate the top layer of the skin in a controlled way and regenerate new skin. It treats wrinkles, acne, and pigmentation.
In case of melasma, a chemical peel helps reduce pigment formation and removal of pigment laden cells. Newer chemical peels have greatly reduced side effects such as burning sensation, redness and exfoliation but comparable results. A series of monthly peels may be required for complete clearance of peel. Post peel precautions would be the same as before the peel.
12. Why do you need to see a dermatologist?
While you wait and hope for melasma to fade, chances that it may spread and become darker is greater. The darker the patches and longer the time the melasma is present it may become resistant to treatment and take a long time to fade. So, I would advise to seek dermatologist help at earliest.
Your dermatologist may suggest you prescription strength skin lightening creams or medication and supervised chemical peel that suits your skin type. Combination treatment helps you attain a clearer skin that you dream.
Contact Details:
Dr. Prativa Shrestha: MD, Dermatologist at Glow Skin and Dental Clinic
Location: Thadodunga, Dhobighat
Email: glowskindental@gmail.com
Contact No.: 9745615656, 9828915936
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