Even the most confident amongst us might feel a little deflated when those grey-brown patches start appearing on our faces. You are not alone! Melasma, an extremely common type of hyperpigmentation, may be notoriously hard to reverse, but good and visible lightening is certainly possible. Here, Dr Stephanie Ho of Stephanie Ho Dermatology discusses all things melasma – from what it is to treatment options. They include topicals, oral medicines and FDA-approved devices such as Sylfirm X.
All about melasma – what is it and is it common?
Melasma is a common skin condition that results in symmetrical greyish-brown patches appearing on the face, often around the cheeks, forehead, nose and upper lip. Interestingly, studies show that the condition is much more prevalent in women than in men. Various factors such as hormonal medication (for example, birth control pills), sun exposure, genetics, and hormonal changes during pregnancy (hence some call it the “mask of pregnancy”) can trigger melasma.
Melasma treatments from oral medicines to lasers
“The first line of treatment for melasma would be strict sun protection and medical grade lightening creams,” explains Dr Ho. “Secondly, oral medicines such as oral tranexamic acid have been shown to be highly effective at lightening melasma. These oral medicines are usually prescribed for around six months to suitable individuals. A large majority of patients will see a visible improvement over that time.”
As melasma often coexists with other pigmentation such as freckles and sun spots, Dr Ho suggests using pigment lasers to target these other pigmentation in addition to melasma treatment. Gentle picosecond lasers can also be effective for melasma control. Finally, devices such as Sylfirm X microneedling radiofrequency have increasingly shown good evidence and efficacy in our fight against melasma. “Regardless of the treatment used, melasma is a chronic condition that may flare with repeated sun exposure. So, strict sun avoidance is imperative.”
An FDA-cleared melasma treatment option
According to Dr Ho, melasma responds best to treatments that aim to improve the microenvironment of the skin and enhance skin quality in a targeted manner. Enter Sylfirm X, which is the first FDA-cleared radiofrequency microneedling device with Pulse Wave and Continuous Wave technology. This tailored combination of microneedling and radiofrequency allows energy to reach the targeted depth and area. This achieves precise treatment and minimises damage to the surrounding healthy tissue.
This targeted approach not only maximises effectiveness and reduces downtime and side effects; Sylfirm X is also able to create microchannels that can be used to deliver actives such as lightening or brightening serums to a specific depth for enhanced penetration and efficacy.
A melasma treatment that is customisable and flexible
Dr Ho explains that Sylfirm X offers the flexibility of tailoring treatments to suit the specific needs and skin types of individual patients. This includes difficult-to-treat conditions like melasma. Such customisation ensures optimal results for each patient’s unique concerns, characteristics and severity of their melasma.
Sylfirm X is also a great treatment for scars and post-inflammatory hyperpigmentation
Because of its customisable and tailored nature, Sylfirm X ensures precise heating and effective treatment for a multitude of skin concerns other than melasma. These include rosacea and post-inflammatory hyperpigmentation (treated with Pulse Wave), as well as acne scars, fine lines, enlarged pores and skin laxity (treated with Continuous Wave).
In fact, Dr Ho reveals that many patients experience significant improvement in their skin’s microenvironment with Sylfirm X treatments. The stimulation of collagen production and skin regeneration can lead to long-term benefits, including improved skin texture, tone and overall appearance.
Combination treatments at Stephanie Ho Dermatology
At Stephanie Ho Dermatology, Sylfirm X is administered following a generous amount of numbing cream, so that there’s little or no discomfort during the melasma treatment. Dr Ho and her team have experience with a comprehensive range of lasers and aesthetic procedures. This allows them to integrate Sylfirm X with other treatments such as picosecond lasers and injectables to enhance the treatment further.
According to Dr Ho, patients especially appreciate combination treatments as they often yield noticeable results even after a single session. For example, Sylfirm X paired with the Picoway laser can treat melasma and improve pore size. Meanwhile, Sylfirm X paired with Botox, Profhilo, Rejuran or Juvelook can reduce wrinkles and stimulate collagen production on the face. And when it’s combined with exosomes, it can regenerate hair follicles and promote hair growth.
Sylfirm X can be used to treat all skin types from light to darker skin individuals, addressing not only melasma but also post-inflammatory hyperpigmentation, acne scars, fine lines and rosacea.
Who isn’t suitable for this melasma treatment?
While Sylfirm X is versatile and suitable for most patients, Dr Ho notes that there are certain conditions that may prevent some patients from undergoing this treatment:
- Patients on isotretinoin for acne
- Patients with an active cold sore breakout
- Patients with an active skin infection, psoriasis or eczema
- Patients who are receiving chemotherapy, radiation therapy, are pregnant, or are taking anticoagulants
Little discomfort and downtime
Dr Ho explains that the generous amount of numbing cream ensures a comfortable treatment experience. Most patients find Sylfirm X treatments to be comfortable and quick, with minimal downtime and little to no pain. Some may experience a slight tingling sensation or light pressure, depending on the depth and area treated. The ultra-fine gold-plated needles are incredibly thin at only 300 microns, says Dr Ho. This helps to make the treatment very tolerable.
How quickly can we see results?
After undergoing this melasma treatment, some patients may notice visible improvement right after the first session. Meanwhile, others may only notice subtle early changes. More significant and visible results typically start to appear a few weeks after treatment. That is when the skin begins its natural healing and rejuvenation process.
The more visible effects of fading and lightening of pigmentation are generally observed after completing a series of three to six monthly treatments. That is when maximal collagen regeneration and skin remodelling take effect.
Regular follow-up sessions may be recommended to maintain and further enhance the results. It can also be combined with other picosecond laser treatments and injectables for optimal rejuvenation, even after just a single session.
A bit about the founder of Stephanie Ho Dermatology
Dr Stephanie Ho is a British trained Consultant Dermatologist who is registered as a skin specialist both in Singapore and the UK. She has over 25 years of medical experience, and has practised in Edinburgh, London, Hong Kong and Singapore. Her special interests include dermatological and laser surgery, skin cancer screening and treatment, scar treatment, and acne treatment.
She set up her private practice in the heart of Orchard, providing services spanning medical dermatology (skin rashes, acne, eczema, skin cancer screening), paediatric dermatology (allergies, warts, skin infections, mole removal), cosmetic dermatology (lasers, injectables, facials, peels) and surgical dermatology (removal of moles, cysts, milia, skin lumps and bumps, skin biopsies, skin cancer removal). She’s fluent in English, Mandarin and Cantonese.
Stephanie Ho Dermatology
#08-05, Scotts Medical Center, Pacific Plaza, 9 Scotts Road
6262 0880 | stephanieho.com.sg
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