Melasma: New Treatment Options and Challenges
Plasma For Melasma in Dallas and southlake
Treatment of resistant melasma with PRP PlasmaGenesis
Micropen + PRP Topical + PRP dermal injections for treatment of melasma and other deep hyperpigmentation disorders in Dallas and Southlake
Healthy Tissue Regeneration with PRP Improves Wrinkles, Scars and Pigmentation. PRP is beneficial to reduce melasma resistant to conventional therapy
What is Melasma?
Melasma is chronic hyperpigmentation of face secondary to hormonal changes. More common in darker skin types, but also seen in individuals with lighter skin. I have seen patients with melasma for 20 years and have found it to be a challenging skin condition.
Melasma presents as a symmetrical medium to dark brown pigmentation of forehead, cheeks, jawline, upper lip and chin, in any combination. The pigment usually involves superficial and deeper layers of skin, i.e epidermis and dermis and is worsened by sun exposure.
For satisfactory melasma treatments, the most important points to get across to the patients are:
A series of combination treatments is usually required for significant improvement and no single treatment will lead to dramatic results.followed by a maintenance program.
Melasma treatments will likely lead to an improvement and not complete removal of pigmentation. Daily effective sun protection is ESSENTIAL to achieve and maintain the results of skin lightening treatments. Use of appropriate sun protection is needed even on cloudy days.
For our treatment of melasma in our Southlake and Dallas patients, we use a combination of prescription and non-prescription skin crèmes along with one or more of the following cosmetic skin treatments to complement the results of the topical skin lightening products.
3. Chemical peel
5. Micopen + PRP or “Plasma for Melasma”
Microdermabrasion for Melasma Treatment:
As a stand alone treatment, microdermabrasion does not lead to significant improvement for melasma but a series of microdermabrasion treatments can be combined with a prescription skin lightening agent for considerable improvement of melasma over several months in some patients.
Micropeel for Melasma Treatment:
Micodermabrasion immediately followed by a very high concentration of Retin-A peel leads to removal of several layers of superficial skin cells and this treatment can be combined with prescription skin lighteners for improvement of melasma over several months.
Chemical Peels for Melasma Treatment:
We use a custom skin peel with TCA and hydroquinone for some of our melasma patients. A series of chemical peels with the use of prescription skin lightening agent in between chemical peels has worked very well for some of our melasma patients.
Micropen for Melasma Treatment:
The MicroPen device works with the body’s natural immune response in a treatment called “percutaneous collagen induction therapy” (PCIT). The instrument’s tiny needles penetrate the epidermis and dermis (2 outer layers of skin) in a very controlled, precise manner. These micro-injuries to the skin stimulate the body to produce new collagen and elastin – the support system of the healthy skin. As the treated area heals, smoother, more even, healthier-looking skin appears. Micropen treatments remove several superficial layers of skin and open microchannels for better absorption of cosmaceuticals. This property can be used to improve the results of topical skin lightening agents. We find the Micropen + PRP to be more effective for melasma in our patients resistant to other treatments
PlasmaGenesis with PRP “Plasma for Melasma”:
Is Plasma for Melasma an option for those suffering from chronic hyperpigmentation secondary to hormonal changes?
We initially treated a handful of patients with melasma resistant to other treatments about in 2015o after extensive research on the effect of PRP on pigment disorders. These patients showed significant improvement with PlasmaGenesis compared with the results they had with the traditional melasma treatments. Since then we have treated a number of patients with melasma with remarkable improvement in skin texture, fine lines, acne scars and sun spots from Micropen treatments.
For melasma treatment, we treat the entire face with Micropen using hyaluronic acid as skin lubricant followed by immediate application of PRP. Interestingly for significant improvement in melasma, PRP needs to be injected in the middle to deep dermis to actually stabilize the melanocytes and topical application with micropen is never enough. We routinely recommend starting with three sessions of Micropen + PRP + PRP dermal injections for melasma patients spaced 6-8 weeks apart. We keep our patients on their prescription skin lightening crème in between the treatments. On average, our patients notice 20-30% improvement within weeks after their first treatment and continued improvements after each treatment.
Who is a Candidate for PlasmaGenesis for Melasma?
We realize that plasma for melasma is not an option for everyone due to several factors:
1. Cost: PRP injection + Micropen is $645-$745 per single treatment
2. More invasive: PRP + Micropen + dermal PRP injections is more invasive treatment than topical prescription with Microdermabrasion, micropeel and chemical peels. There is a number of patients who respond well to these less invasive treatments.
3. Systemic illness: PRP cannot be done if you have a history of cancer, any blood disorders and if you are taking blood thinners that cannot be stopped due to medical reasons.
Advantages of PlasmaGenesis for Melasma Treatment:
There are certain advantages of PRP and micropen treatments with dermal PRP injections:
1. Improvement in texture, fine lines, scars is significantly more with this treatment than the other options
2. PRP can be injected in the under eye area, nasolabial folds, prejowls to induce collagen in these areas which provide an anti-aging treatment and minimizes the need for a dermal filler for some of our patients
3. Probably the best option for individuals resistant to less invasive treatments of melasma and hyperpigmentation.
4. PRP + Micropen does not seem to induce post-inflammatory pigmentation (PIP) in patients with darker skin types which is a big limiting factor in choosing the right skin treatment for pigment reduction in a lot of these patients.
5. Very little downtime compared with TCA chemical peels. Most patients have mild redness lasting 1-3 days and mild swelling at the injection sites which lasts 2-4 days, occasional bruising which can be easily covered with a concealer.
There is no hard and fast rule for a set number of plasma for melasma treatments. The results of each treatment are cumulative and dependent on your body’s collagen production after each treatment. We recommend starting with three treatments, 6-8 weeks apart followed by maintenance treatment once every 8-12 months. Individuals with very deep pigmentation and extensive scarring may require more than three treatments to get the desired results and those with lighter pigmentation and few shallow scars may do well with one plasma for melasma treatment followed by a series of microdermabrasion/micropeels for further texture, pigment improvement.
How to Prepare for Your PlasmaGenesis for Melasma Treatment?
For your plasma for Melasma treatment in Dallas and Southlake, you will need a consultation to determine if you are a candidate for this treatment. At the time of your consultation, realistic expectations, possible side effects from the treatment and the number treatment recommended will be discussed with you.
To prepare for your plasma for melasma treatment in Dallas and Southlake, you need to do the following:
- Stop taking aspirin and any other NSAID for two weeks before your treatments
- Stop blood thinning oral supplements such as vitamin E, fish oil, krill oil for 10 days before your Plasma for Melasma treatment
- Stop alcohol for a minimum of five days before your plasma for melasma treatment.
- Take Vitamin C 500 mg/day starting 2 weeks before your plasma for melasma treatment.
On the day of your plasma for melasma treatment in Dallas and Southlake, you are requested to arrive 30-40 minutes prior to your appointment time. Our nurse will apply a topical numbing medication on your face and draw one small tube of blood from your arm vein, similar to your routine blood work at your medical doctor’s office. She will centrifuge your blood in a special container to separate your “Platelet Rich Plasma” from your red and white blood cells. Not all PRP kits are the same. We use Harvest to obtain PRP for PlamaGenesis of Skin.
How is the “Plasma for Melasma” treatment done?
Once the PRP is prepared, she will clean your face with a medical/surgical grade antibacterial skin cleanser. She will use pure hyaluronic acid as a lubricant during the Micropen facial treatment. Typically she will go over areas of deeper scars 3-5 times using very gentle pressure and circular motion. She will apply use a small amount of your PRP to the treated area. The remainder of your PRP is reserved for dermal injections for areas of deeper pigmentation. Immediately following your plasma for melasma treatment, you will have mild redness all over from the Micropen, some swelling and occasionally some bruising in the areas of injection
We ask you to leave the skin untouched until the next morning when you can wash your face with a gentle cleanser.
We give a prescription for custom compounded skin lightening crème, mixed for you at compounding pharmacy located in Arlington Texas. For our out of town patients, the pharmacy can mail your prescription crème at no extra charge.
We see you for a follow-up in 6-8 weeks for your second treatment or to start your microdermabradion or micropeel, depending on your personalized melasma treatment program
To find out if you are a candidate for plasma for melasma treatment in Southlake and Dallas, please call 888-210-9693 for an appointment.