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If you suffer from Melasma, take heart you are not alone, it is the bane of their existence for millions of women and is one of the leading sources of patients for aesthetic dermatologists and doctors worldwide. Pigmentation is the N°1 most frequent motive for dermatological consultations in Nepal, 3rd most frequent in the U.S.A. and Brazil, and 4th most frequent in Saudi Arabia.

So what exactly is Melasma ? Melasma appears on the skin when there is an over-production of the pigment melanin. There are three types of melasma, usually referred to as epidermal, dermal and mixed (a combination of epidermal and dermal). Melasma most often appears on the central face 63 percent, cheeks and nose 21 percent and jawline 16 percent of cases. In rare cases it can appear on other regions of the body, such as the forearms. The severity of the Melasma is often determined using the Melasma Area and Severity Index (MASI) scores. The common factor among all affected body areas is their exposure to the sun.  

There are several other implicating factors in Melasma : the most frequent causal factor is pregnancy. It affects 42 percent of women during or after pregnancy. Another risk factor is a family predisposition, from a genetic standpoint : 48 percent of suffers have close relatives ; a first-degree family member, i.e. a parent, sibling or offspring who also develop Melasma.

Women using hormonal birth control do not necessarily run the risk of having Melasma, however, if this contraception is combined with specific genetic predisposition, then the risk of developing melasma is multiplied by 250% percent, which is highly significant.

Those who expose their skin to the sun rays are the prime candidates for developing Melasma. Analysis of 30 years of satellite data by NASA scientists in the USA, found that the amount of ultraviolet (UV) radiation reaching Earth’s surface has increased significantly over the last three decades. The biggest increase has occurred in the mid-and-high latitudes and in southern hemisphere due the ozone hole.

High risk candidates living in the southern hemisphere, or close to the equator are therefore specifically prone to Melasma, as are populations living around the Mediterranean region, Asian and dark skinned populations who are statistically more prone to Melasma.

What is the impact of Melasma on people’s everyday lives ?  Although it varies depending on individuals’ personalities, it often has significant negative effect on the individuals’ daily life. Often, there is a partial or complete loss of self-confidence ; other suffers focus excessively on their hyperpigmentation, applying excessive makeup to conceal it or seek to avoid social contexts entirely. The main impact is therefore psychological.

So what can be done to help treat or reduce the appearance of Melasma ? One of the frequently proposed solutions is laser treatment. The laser light is absorbed by the melanin – or pigment – in the skin causing heating and disintegrating of the pigmented cells which eventually form a scab and fall off. However, in darker skin types, there is a risk of suffering from inflammation, irritation or even burns which can potentially lead to post-inflammatory hyperpigmentation.

Laser treatments are also quite expensive, which may prove prohibitive for some patients. Generally speaking lasers can be effective if the pigmentation is well-defined such as a lentigo or sun spot in lighter skin types. However studies report temporary to minimum improvement in Melasma and in some cases lasers can actually worsen some types of Melasma. There is also a risk of hypopigmentation i.e. a permanent depigmentation of the skin, even in lighter skin types. Laser therapy is consequently not the ideal solution to treat Melasma and should be used with caution.

Another treatment solution available are professional chemical peels ; performed by a medical professional. This type of treatment combines an acidic PH solution which exfoliates the skin surface and thus enables better absorption by the skin of the second part of the treatment which is a topical skincare cream protocol. This is achieved through a cream comprised of depigmentation agents, applied at home on a daily basis, to target the overactive melanocytes, the cells responsible for excess pigmentation. This homecare protocol should also include creams with anti-inflammatory ingredients and UV filters in order to calm and prevent the over stimulation of the melanogenesis.

It goes without saying that “prevention is better than cure”, so the first golden rule in the treatment of Melasma is to avoid intense and prolonged sunlight. However, if in spite of all your efforts you do suffer from Melasma, then the Uniq White System by Nunii Laboratoire is the solution for you. NUNII strives to bring new solutions to patients and dermatologists with the development of innovative and scientifically proven treatment solutions. NUNII’s core ethos is to find ever-more efficient molecules and formulations to target pigmentation problems and improve patients’ quality of life, while removing the risk factor for the patients in these treatments. This endeavour is backed through our close collaboration and partnership with the U1065 of INSERM (The French National Institute of Health and Medical Reaserch), the world renowned research laboratory, with a research focus on the genome responsible for product of pigmentation in the skin.

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Source : Wikipedia

The Fitzpatrick scale, or Fitzpatrick phototyping scale, is a numerical classification schema for human skin colour. It was developed in 1975 by Thomas B. Fitzpatrick as a way to estimate the response of different skin types to UV light. See diagram below for the different skin types.