Monday, July 1, 2013

Melasma, Pregnancy Mask, Paño.....

Darkening of the skin, or also known as Melasma, is one of the most frustrating skin condition that afflicts mostly women. Generally, olive to darker skin individuals are more likely to be afflicted than their light skin counterpart. Cheeks, nose bridge, forehead, eyebrows, mustache, are the most common patterns of this annoying condition. The onset of this condition goes back as early as the teenage years when we are not in the position to listen to our parents' warnings. Early and careless exposure to sunlight at that age may set skin cells to remain sensitive to the sun. "But these dark spots appeared barely two months ago" is a common explanation that I get from clients who swear that they did not have anything like this before. Well, there is a partial fact on that. Skin cells and blood cells have been known to have good memories and, more likely, they don't forget early abuses. What we fail to appreciate at those younger years is the efficiency at which our skin repair itself, almost over night. A fun weekend and long hours under the sun would give us an attractive tan, then the skin would replace those superficial damaged cells and two weeks later, it would get back to normal. But deep in their micro bodies, those skin cells would pass down to other younger cells this experience and also the damage control process in how they successfully contained the abuse.

Skin cells, though, do not produce the darkening, melanin does. Melanin is a dark substance produced in the deep layers of our skin. It provides us a distinctive hair color as well as skin tone. The darker the skin the more melanin is present. Melanin in our skin acts very similar to the tint install on a car's windows. It protects the inside from the sun and maintains it cool. Unlike the car tint, the production of this a marvelous substance is automatic and it acts also as a defense mechanism. Superficial skin cells activate melanin production when they perceive a threat, mainly from sun exposure but not limited to. An easy way to picture how melanin covers the immensity of billions and billions of skin cells is by imagining a grapevine. It grows thicker at the very bottom of the dermis and expands its micro "branches" throughout  the epidermis in upward patterns. In fact, what we get to see with our naked eyes on the surface of our skin are just the massive amount of residues of this "tinting" manufacturing process. Its presence remains active throughout our life, though, losing its accuracy and uniformity as we grow older. Sadly, we all get to experience its flaws when we start seeing those "old age" spots. But again, most of those dark spots did not appear overnight.

By now, you should have a less blaming attitude against your superficial skin cells, but, wait, do not shift the blame to melanin, not just yet. Whenever we suffer an irritation, a burn, a cut, a scratch, or any deep injury on our skin, superficial cells are the most efficient and crucial living beings that get involve. They jump into action and trigger a massive cascade of emergency protocols. To name every single emergency protocol, we might need to write a book on the subject, so let's stay close to our topic. Massive production of melanin gets into high gear under those circumstances and you will find out why. Injured cells and tissues need to have a separate, delicate care from the rest of the healthy area. In theory, the darkening plays a guiding signal of identification for other specialized cells that are on their way to assist and repair. Once the repair is done and healing takes over, it is actually melanin what will effectively ensure that those cells and tissues continuously receives an extended care. Just imagine a warm blanket over your injured body. Melanin and collagen are more abundant in darker tones, for the better or for the worst, this is what define how long the actual darkening would remain on the surface.

So what all of that explanation has to do with Melasma? Well, melanin most respond to various commands from various sources. Its intrinsic and delicate mechanics, its chemical composition of melanin, its intimate relationship with healthy or damaged skin cells and the fact of being part of our immune system's response, this substance is subjected to a lot of demands . Remember that skin cells have very good memory as far as exposure to danger is concerned; it is their survival instinct to retain that memory in case of similar aggravations in the future. In theory, long sun exposure or deep and larger injuries can and will leave longer memory impressions on this organ called skin. And that is why melasma is a skin problem that needs special attention and customized approach. There are plenty of factors that could have triggered the darkening.

Pregnancy plays a significant roll due to the major changes that a woman's body will submit to but, in those cases, I always suggest to try out customized cooling masks and mild skin lighteners. This darkening will fade away as long as the person does not insist for intense treatments. Mild skin lightener products with small amount of Hydroquinone work well (Hydroquinone is an active ingredient always present in any bleaching cream. Over the counter carries the allowed amount which is 2%. Prescribed bleaching creams carries up to 10%.) Higher percentage delivers quick results but at a cost of producing irritation on the superficial skin cells. As mentioned before, what follows irritation is always the darkening of the skin. Faster relief but, honestly, you may be prolonging the problem.

Long term prescribed medicine take a toll on the skin. Medicine residues travel and accumulate at almost any part of our bodies. When those tiny foreign particles reach and remain on the walls of, lets say, blood vessels, especially on the surface of our face, they might trigger irritation. Once irritation stays constant, those blood vessels will emit signal of stress and the skin might interpret that as a threat. Remember, skin cells would not play around when it comes to protect their own and as soon as something triggers their stress response, melanin is the first substance that goes alone with it. An experienced skin specialist would differentiate between common melasma and this effect caused by long term medicine. This condition, though, can be very stubborn to respond to treatment as long as the person continues taking the medicine. Under this situation, I have observed that melanin deposits under the superficial skin cells become so thick that they resemble charcoal particles embedded in the skin.

Darkening also is associated with some work environment. Long hours under the sun will have permanent damage on the skin. If you have a darker complexion, you are fortunate that those skin damages will amount to cosmetic issues and premature aging. Sunlight can bring some very devastating effects on our skin. As it travels deep in our skin, it destroys all those delicate linings and connective tissues. Fortunate, melanin will mitigate most of that by turning exposed areas darker therefore blocking sun rays. On those cases, treatments can promote new skin cells to the surface and, as the skin is forced to repair itself, customized masks and moisturizers should be recommended to immediately manipulate and minimize the darkening effect. Few treatments are usually recommended and results depend on how consistent products application are applied and, something crucial, the person must wear appropriate hats. Sun protective creams are okay but one cannot rely entirely on those. They are just creams that act as sun filters but never should they be considered as an absolute sun protection. The sooner the person begins treatments, the sooner the damage will slow down and repair will follow. Delay to treat this condition will have cosmetic repercussions that last a life time. I also have observed some other skin imperfections that resemble moles or rough and elevated skin surface from clients who have been exposed to direct sun.

And then the typical melasma that, for the most part, appears after the 30th birthday. This is the most stubborn case. A common denominator among these clients who suffers this skin malady is the unfortunate fact that they have submitted their skin to A through Z treatments as well as products. In these cases, the essential part of the treatment begins by listening to them and their stories of what their skin has been exposed to. I have heard stories and seen devastating outcomes. One can only weigh and measure the extend of each case. I prefer, even against their expectation, to take a slow approach that allows the skin some time to recuperate on its own. Surprisingly, these clients are so demoralized about their skin appearance that they beg for quick and "intense" treatments! When the approach is intense by using higher hydroquinone formula, the lighting effect can be seen within 5 to 15 days. Redness will take place, a sign that superficial cells are getting irritated. The longer the exposure, the longer the problem will last. Let's keep in mind that darkening is an accumulation of some years of sun damage, aggressive treatments, poor diet or food containing excess of salt or sugar, stress, bad habits like smoking. As far as I'm concerned, there is not a quick fix to reconcile all of that in one laser treatment or chemical peel. The ideal approach is, again, to do  mild treatments and to use the lower strength of product formulation. It might  take longer to see some results but at least the skin is not being punished to do its job.
Another fact to take in consideration is the consumption of dietary supplements that promise a large variety of cures. They not only do not deliver their promises but have the potential of altering the inner works of the skin. When people decide to take those questionable juices, pills, and shakes, they inadvertently over load  all those sensitive tiny ducts with unfriendly chemicals. Those micro ducts expels sweat to the surface of the skin and that chemistry might trigger many unknown reactions. Salt also promotes similar reaction. As I always tell my clients, there is nothing wrong with eating fruits, vegetables, and drinking plain water. Stress generally affects all  our organs and body. Our skin, which I believe is the largest extension of our brain, receives and perceives all our despondent attitudes. I'm sure you know what I'm referring to. Those episodes when you feel down and your face will tell the rest of the story to the world. Yes. Your complexion changes and so your skin tones. I can't help sounding like I'm preaching to my audience; however, I'm trying hard to lay out all of those offending factors. I fully support a person who becomes aware that melasma is not a skin disorder that would go away over night. It will require customized attention to address it effectively. In most cases, I have either minimized it completely or my client learned what has been the origin or the triggering factor.  Good luck to you and feel welcome to drop your comments and I'll be happy to provide more suggestions. Thank you for reading.    





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