Melasma is a tricky skin companion that loves to invade our faces with patches of dark pigmentation. It is not painful, yet it can be distressing, and you’re definitely looking for the most efficient way to get rid of it.
When sunscreens and over-the-counter topical products fail to work and you’ve concluded your melasma is a hopeless case, you resort to a more aggressive yet effective solution: chemical peeling.
But, what is the best skin peel for melasma?
You can choose from several peeling solutions whose name you can’t even pronounce. But there’s no one-size-fits-all approach to treating melasma. The best chemical peel for melasma depends on your skin type and what triggers its formation.
Below, we’re going to talk about everything you need to know about melasma. We’ll also explore different skin peel solutions to help you achieve a brighter complexion.
What Is Melasma?
Also referred to as “pregnancy mask,” melasma is a skin hyperpigmentation condition characterized by dark brown patches. It appears mostly on the face, but it can also show up on other parts of the body including the shoulder, neck, and arms.
The true cause of melasma is not known. However, it is said to be related to hormone production, genetics, certain medications such as antiepileptics, thyroid issues, and even stress. The UV rays are also one of the main causes.
When there you are frequently exposed to the sun, there is an excess melanin (natural pigments) production within the skin cell’s melanocytes. This could result in dark brown spots and uneven skin tone.
The reason melasma is referred to as the mask of pregnancy is because they are more common among pregnant women. This is due to the overproduction of hormones during pregnancy. That said, melasma is not painful or dangerous. But it can be uncomfortable for some patients.
Melasma vs Sun Spots
Both skin discolorations can look and act alike. However, they can come from different triggers.
Sunspots are exactly what they are. These are brown splotches caused by the UV rays emitted by the sun. However, unlike melasma, sun spots don’t show up right away. Instead, they work their way to the surface for many years. They can exist in your skin and won’t be visible to the naked eye.
Melasma, on the other hand, can be triggered by a range of factors mentioned above. And when you have it, they appear on the skin as these dark brown symmetrical patches. It is more common in women than men, while sun spots can affect anyone—regardless of age and gender.
Melasma is also more visible in patients with darker skin types while sunspots affect those with lighter skin tones due to the lack of melanin. And when it comes to treatment, melasma does not respond as well as sun spots, making it harder to treat.
Treatments for Melasma
Since the triggers of melasma come from various factors, it is incredibly hard to treat. Topical solutions are the mainstay treatment for such skin discoloration. However depending on the case and cause, a dermatologist’s intervention may be required.
As with sun spots and sun damage, one of the main triggers of melasma is UV rays due to sun exposure. Sunscreen is a great first-line defense against melasma. A broad-spectrum sun protection factor of 30 or higher is recommended.
Wearing SPF both indoors and outdoors, regardless of the weather, is a must for everyone. Not only could it help prevent melasma, but doing so also helps fight premature aging and sun damage.
Chemical peels come in handy for treating melasma. They come in many forms with strength variations. Chemical peels contain key ingredients (acid) to target skin hyperpigmentation through exfoliation and clearing of superficial lesions. It removes dead skin cells, allowing the skin to regenerate new epidermal and dermal tissues.
When opting for chemical peeling, it is important to consult with a board-certified dermatologist. Visiting a reputable clinic or spa can help you assess which chemical peel best suits your skin type.
What Is the Best Chemical Peel for Melasma?
Treatment for melasma is multi-pronged and there is not a single best chemical peel for all patients. And because melasma affects mostly dark-skinned patients, mostly those in the IV-VI range of the Fitzpatrick scale, certain chemical peels could worsen the hyperpigmentation. This makes it notoriously hard to treat.
However, chemical peels are generally applied on epidermal and mixed melasma to avoid further scarring and permanent depigmentation. It is important to note that each chemical peel is used with different strengths and applications, depending on the patient’s skin type and condition.
Trichloroacetic Acid (TCA)
TCA peel is one of the stronger and more common chemical peeling agents. It is also highly effective for treating post-inflammatory hyperpigmentation (PIH). TCA peels can be used to penetrate the skin deeply at a higher strength of 35%. It can also be done in separate sessions until the discolorations are shed away.
That being said, it is not the most effective for non-surface level melasma. The TCA solution is typically used in patients with a lighter skin tone due to its risks and side effects in darker skin tones.
Alpha Hydroxy Acid (AHA)
AHA peels like glycolic acid peels are common solutions used to treat acne scars and melasma. Glycolic acid chemical peels are typically used at 30-70% and work well on ethnic skin. It typically requires several sessions and can be used in combination with other topical solutions such as azelaic acid, topical vitamin C, and adapalene.
Lactic acid peels are another form of alpha hydroxy acid that works similarly to glycolic acid peels. Even with over 90% lactic acid solution, it is safe to use on all skin types. It is comparable to the efficacy of Jessner’s Solution and is inexpensive.
Beta Hydroxy Acid (BHA)
BHA peels such as salicylic acid are another safe alternative for treating dark spots. Although salicylic acid peels often target acne, the acid peel typically contains Jessner’s Solution, lactic acid, and resorcinol. Salicylic acid chemical peels have great anti-inflammatory properties and what it does is it prevents PIH from forming.
Combining salicylic acid and mandelic acid, which is another form of alpha hydroxy acid, also makes an effective peeling agent. Mandelic acid works by penetrating the epidermis slowly and uniformly. In combination with salicylic acid, the chemical peel will cause less inflammation and reduce the formation of PIH.
Jessner’s peel has been widely used as a superficial peeling agent to treat melasma. It is comparable to alpha hydroxy acids as it contains other forms of alpha hydroxy acids, beta hydroxy acids, and resorcinol in the solution.
However, for a medium-depth chemical peel, it can be used in combination with either TCA peel or glycolic peel.
The combination of the two acids is a staple among professionals since melasma has a convoluted cause. With a mix of low-dose TCA, for example, you get a more even penetration and effective peel. However, the other ingredients added to the Jessner peel solution depend on a patient’s skin complexion.
Tretinoin or retinoic acid is a concentrated form of retinoid. In its topical form, it is widely used to treat acne and sun damage. While there is still not much research done on the formulation of tretinoin peels, according to the National Institutes of Health (NIH), the peeling agent has shown promising results in a few recent trials.
A 5-10% tretinoin peel solution is enough to appreciate slow peeling to remove skin pigments while reducing age spots and improving skin texture.
Azelaic Acid is a bleaching agent used to lighten dark spots on the skin. It works by blocking the production of melanin, which can help lessen the dark spots associated with melasma. This acid peel is less irritating than other forms of treatment, making it safe for all skin types, including sensitive skin.
In the quest for solutions to control and eliminate melasma, there is no single best treatment to clear those pesky patches off the skin. The best chemical peels for melasma depends on your skin type. It is also important to know the cause of its formation.
Certain chemical peels are milder than others. However, some skin types need time to build resistance to the acid or require a gentler approach to addressing melasma. If you are looking to invest in a treatment soon, consult with a board-certified dermatologist for a more personalized treatment.