Melasma is a condition that causes dark spots on the skin. It can occur on the face, neck, chest, and upper arms. Melasma most commonly affects women who are pregnant or taking birth control pills. It also affects people with darker skin types. Melasma can be treated with medication, but some people prefer to try other treatments such as chemical peels.
Chemical peels can improve the appearance of melasma by removing damaged layers of skin from the face and revealing new skin underneath. There are many different types of chemical peel for melasma treatment: alpha hydroxy acid (AHA), trichloroacetic acid (TCA), Jessner’s solution, glycolic acid, salicylic acid and phenol.
Read on to learn more about What To Know About Chemical Peel Is Best For Melasma What To Know About Chemical Peel Is Best For Melasma, Who Is a Good Candidate For a Chemical Peel? and What To Expect After the Chemical Peel
What To Know About Chemical Peel Is Best For Melasma
Melasma, a skin condition characterized by gray or brown patches that develop on the surface of the skin, can be very upsetting for patients. For many, hyperpigmentation or discoloration on the face can lead to feelings of self-consciousness aesthetically and concern for overall skin health. The trigger for developing the condition can vary from person to person, though common risk factors include too much exposure to harmful UV rays from the sun or tanning beds, hormone fluctuations or genetic factors. The condition is not rare and affects a large percentage of the general population. It is most common in women between the ages of 20 and 40 and those with darker skin types, falling within the IV-VI range on the Fitzpatrick skin type scale. Melasma is also sometimes referred to as the “mask of pregnancy” and between 15 and 50% of pregnant women develop the condition throughout their pregnancy. Concern for appearances or for overall skin health often has patients with melasma looking for a way to rid themselves of the condition. Luckily advancements in dermatology mean that your melasma can be easily treated with the help of chemical peels.
Chemical peels are skin resurfacing treatments that involve the application of a chemical mask. This mask reacts with the dead skin cells present on the outer layer of the skin to gently exfoliate the area. This process triggers the body’s natural healing process, promoting cell turnover for healthier skin. Chemical peels are extremely effective in treating melasma and removing discoloration on the skin. When applied to the affected area, chemical peels work not only to lessen the appearance of hyperpigmentation but also to prevent the accumulation of melanin in the skin, which leads to the discoloration on the skin. For that reason, as long as strict sun avoidance is practiced, chemical peels can help to prevent melasma from occurring again in the future. The process is safe and effective when performed in the office of an expert dermatologist, such as Dr. Michele Green.
Dr. Michele Green has been expertly treating skin conditions of hyperpigmentations, such as facial melasma and post-inflammatory hyperpigmentation in her Upper East Side New York City office for over 25 years. An expert in chemical peels, melasma, skin care, microneedling and laser treatment, Dr. Green has been consistently voted as one of the best dermatologists in NYC by The New York Times, Castle Connolly, Super Doctors, and New York Magazine. Whether it be treating hyperpigmentation as a side effect of lasers, or dark spots and sun spots from excessive sun exposure, or acne marks and acne scars, Dr. Green will help you rejuvenate and lighten your skin. Dr. Green is an expert in treating patients of all skin tones, including Asian patients and dark-skinned patients. If you are suffering from melasma or hyperpigmentation, Dr. Green is here to help.
What is melasma?
Melasma is a skin condition characterized by patches, or lesions, of brown or gray skin that develop most commonly on the face but can also be found on the arms, back, and chest. On the face, most cases of melasma are symmetrical, affecting primarily the forehead, upper lip, bridge of the nose, and cheeks. Melasma is a relatively common condition, however, women are much more likely to suffer from melasma with the American Academy of Dermatology reporting that approximately 90% of instances of the condition are found in women. Specifically, women aged 20 to 40 are most likely to develop the condition. Th incidence is particular high among pregnant women, with melasma affecting between 15 and 50% of all pregnant women. Women who have darker skin tones, such as those that fall in the IV-VI range of the Fitzpatrick scale, are also more likely to be affected by melasma. Patients with lighter skin types can also suffer from the condition but it is often less noticeable for those with lighter skin than for those with darker skin tone.
What causes melasma?
Melasma is caused by an over-activation of the cells that produce melanin in the skin. Melanin is the naturally occurring chemical in your body responsible for pigmentation. Melanin is produced by cells called melanocytes that are found in the epidermal, or outer, layer of the skin. The amount of melanin produced by melanocytes determines the color of your skin. Melasma occurs when the melanocytes in the epidermis are triggered to produce an increased amount of melanin. This overproduction of melanin leads to patches of excessive pigmentation or discoloration in on the surface of the skin. The exact reason for the overproduction of melanin in the melanocytes is not yet definitively known, however, there are a number of risk factors that sometimes lead to this overproduction of melanin, including excessive sun exposure, hormone fluctuations, and genetic predisposition.
What is the best treatment for melasma?
When thinking about the best treatment method for your incidence of melasma, it is very important to consult with a board certified dermatologist, such as Dr. Green. This is especially important if you have a darker skin tone, as many skin lightening products that are used in the treatment of melasma can have harmful effects on dark-skinned patients. Patients with darker skin types are more at risk of developing post-inflammatory hyperpigmentation (PIH) if you receive treatment from someone inexperienced. Dr. Green is highly adept at treating patients with melasma of all skin types and will inform you of all of your treatment options that are safe and effective for you.
At Dr. Green’s office, there are many treatment options for melasma that range from laser treatments, to topical skin care products, to microdermabrasion, to chemical peels. One of most popular and effective treatments for melasma available at Dr. Green’s office is the chemical peel. There are several varieties of chemical peel available, including peels containing glycolic acid, trichloroacetic acid, and hydroquinone. Chemical peels are extremely effective and demonstrate significant improvement to skin discoloration following the treatment process.
What is a chemical peel?
There are a wide variety of chemical peels, which work to exfoliate the outer layer of skin (the epidermal layer) to rejuvenate the skin and stimulate the production of collagen for a lighter, brighter look. The chemical peel is applied as a liquid, which can contain a variety of different kinds of acids depending on the type of peel being used. These acids react with the dead skin cells on the surface of the skin in order to exfoliate the outer layer. There are different intensities of chemical peels ranging from superficial peels to deep peels, though when treating melasma, Dr. Green will typically recommend a medium-depth peel. The different types of chemical peels are used to treat a variety of other conditions such as acne scars, and fine lines and wrinkles.
Of all the different varieties of chemical peels available, Dr. Green typically recommends the Cosmelan Peel for her melasma patients. The Cosmelan peel is a professional-grade mask applied by Dr. Green in her office that contains active tyrosinase inhibitors, which work to inhibit the production of melanin in the skin. These ingredients include kojic acid, azelaic acid, arbutine, Phytic Acid, licorice, and ascorbic acid. The two-step process of the Cosmelan Peel, which is extremely safe and effective for all skin types, begins with Cosmelan 1, which is applied in Dr. Green’s office and is used to eliminate the dark spots on the skin. Cosmelan 2 is then applied daily (or twice daily) at home and is meant to prevent the formation of new dark spots and continue to treat existing ones. The Cosmelan 2 is then paired with moisturizers and other skin care products designed to help rejuvenate the skin including Hydra-vital factor K or proprietary products from Dr. Green’s MGSKINLABs, such as the MGSKINLABs Recovery Cream.
How do chemical peels work?
Many patients wonder, do chemical peels work for melasma, and the answer is yes. Chemical peels are topical masks that contain acids that react with the dead skin cells on the surface of the skin in order to exfoliate the skin. Depending on the depth of the peel, the mask can effect just the epidermal – outer – layer of skin or penetrate to the dermal layer of skin. When the acids react with the dead skin cells, it causes the skin to gently peel. The controlled injury to the skin removes the blemishes on the surface of the skin and triggers the body’s healing response, which leads to an increased production of collagen.
When it comes specifically to removing pigmentation on the surface of the skin, a chemical peel such as the Cosmelan Peel works on all levels of dark spot treatment and prevention. When the Cosmelan Peel is initially applied, the active ingredients stimulate skin cell turnover, which removes the melanin that has accumulated in dark patches on the epidermal layer of the skin. The peel then works to inhibit the production of new melanin by blocking the production of melanin in the melanocytes and the movement of melanin between the melanocytes and the keratinocytes. This keeps new dark spots from forming on the service of the skin.
Are chemical peels good for melasma?
Patients often ask, can chemical peels remove melasma, and the answer is yes! Chemical peels are an extremely safe and effective way to eliminate and prevent discoloration on the skin as a result of melasma. Chemical peels work by exfoliating the outer layer of skin and promoting the turnover of skin cells. This eliminates the excessive pigmentation in the treatment area. The acids that make up the chemical peels can also work to inhibit further production of melanin to not only remove the melasma on the skin but prevent the formulation of new dark spots as well.
What type of chemical is best for melasma?
Patients often ask, what is the best chemical peel for melasma, and the answer is: it depends though typically, Dr. Green recommends the Cosmelan Peel to treat melasma. The Cosmelan peel is formulated with retinoids and 51 active ingredients, including kojic acid, azelaic acid, and ascorbic acid and works to eliminate the accumulation of melanin on the skin as well as prevent further accumulation from occurring. There are, however, many varieties of chemical peels that are used to treat melasma that use a variety of different ingredients with different mechanisms of action.
Azelaic acid – Azelaic acid is used as a bleaching agent to lighten skin complexion and address pigmentation conditions such as melasma. Azelaic acid works to block the creation of melanin in over-active melanocyte cells and is safe and effective for all skin types.
Glycolic acid – Glycolic acid peels are a common form of alpha hydroxy acid peel that is effective for the reduction of melasma.
Kojic acid – Kojic acid is a tyrosinase inhibitor, meaning that it works to prevent the production of pigmentation in the skin. Kojic acid is used in the formulation of the Cosmelan peel for the elimination of melasma and is effective to be used on all skin types.
Lactic acid – Lactic acid is also an alpha hydroxy acid that is used in the formulation of chemical peels such as the Jessner peel. Lactic acid is safe to use for all skin types.
Salicylic acid – Salicylic acid is a beta hydroxy chemical that is commonly used in chemical peels for treating acne and acne scars. Commonly, salicylic acid is used in the formulation of Jessner’s solution along with lactic acid and resorcinol. Jessner’s peel is a common superficial chemical peel that is effective for all skin tones. Salicylic acid is also anti-inflammatory, which means that it decreases the likelihood of developing post-inflammatory hyperpigmentation.
Tretinoin – Tretinoin (also known as retinoic acid) can be used to treat acne and sun-damaged skin. Tretinoin is often used to treat surface wrinkles, fine lines, and dark spots.
Trichloroacetic acid – Trichloroacetic acid, found in a trichloroacetic acid or TCA peel, is more commonly used for lighter skin patients as there are risks of significant side effects for patients with darker skin. TCA peels are also not as effective for treating melasma that is non-surface level, meaning melasma that is found in the dermis.
What is the process for getting a chemical peel?
When you are ready to treat you melasma, you will begin by having a consultation appointment with Dr. Green. At your appointment, you should disclose any medications or skin care products that you are using at present. Some medications, contraceptives, and skin care products can exacerbate or worse melasma and as such, part of your treatment recommendation may be changing those medications. Dr. Green will also be able to work with you to determine the treatment or series of treatments that would work best to treat your melasma. Dr. Green is also extremely experienced working with patients of all skin colors and knows the treatments that is safe and effective for patients with lighter skin tones and darker skin tones.
Typically, Dr. Green recommends the Cosmelan Peel to treat melasma as it is very effective and safe for all skin types. The Cosmelan Peel involves a two step process: the first step is for Dr. Green to apply the Cosmelan 1 solution in her office. The amount of time that you should keep the mask on your skin – between 4 and 12 hours – depends on the severity of the melasma condition as well as your skin tone. After the allotted amount of time, you can remove the mask at home with a gentle cleanser. The second part of the treatment is an at-home process. Once or twice a day, you should apply the Cosmelan 2 solution, which helps to prevent new melasma dark spots from forming on the skin. Dr. Green may also prescribe a series of moisturizers or vitamin C solutions in order to further promote skin rejuvenation. Three weeks after your initial appointment, patients should return to Dr. Green’s office in order to receive a touch-up Cosmelan mask to remove any lingering pigmentation.
Chemical peels are a treatment option that requires limited downtime, with only minimal side effects. Some common side effects following the treatment is dryness and irritation at the treatment site, which clear up after several days. The severity of side effects is dependent on how deep the chemical peel is. Following the chemical peel treatment process, it is extremely important that you take the adequate steps for sun protection. While chemical peels work to prevent new production of melanin, melasma can still return if you are further exposed to harmful UV rays from the sun. Dr. Green recommends practicing strict sun avoidance by wearing two types of sunscreen (chemical and physical) of at least SPF 50 or staying inside during the time of day when the sun is at its most intense (from 10am to 2pm).
What are the risk factors for developing melasma?
There are several factors that can increase your risk of developing melasma, which include lifestyle habits, such as too much exposure to the sun, consumption of certain products, as well as biological factors, such as hormone fluctuations or genetics.
Exposure to UV Rays – Ultraviolet rays, also known as UV Rays, can have a harmful effect on the skin when absorbed in too high of quantities. The production of melanin in the skin can be triggered as a way for your body to protect you against these rays. Exposure to UV rays occurs when you spend significant time in direct sunlight or from repeated exposure to tanning beds. In order to decrease risk of developing melasma as a result of UV ray exposure, it is best to avoid tanning beds and wear sunscreen of SPF 50 or higher when going out into the sun.
Hormones – Hormone fluctuations can also be a risk factor for developing melasma. One instance in which this occurs in during pregnancy, which is melasma is sometimes also referred to as the “mask of pregnancy.” Certain hormonal contraceptives, such as the oral birth control pills, can also be a risk factor for developing melasma. If melasma starts to flare up while you are on birth control pills, Dr. Green recommends ceasing your consumption of the contraceptive in order to improve your condition.
Skin Care Products – Over time, certain products can worse or exacerbate melasma. Examples include common exfoliants that are used for conditions such as acne, alpha hydroxy acids, any product that makes your skin more sensitive to sunlight, and soaps that are scented. When you have your initial consultation with Dr. Green, it is important to disclose information on the types of products you are using so she can recommend you discontinue their use if they are exacerbating your condition.
Oral Medication – Some medications that you are prescribed to treat a variety of other conditions may cause photosensitivity, which means that they may cause your skin to be more sensitive to the UV rays from the sun or from tanning beds. If you are taking such medications, you may find that your melasma worsens. Be sure to disclose to Dr. Green the oral medications that you are taking before you begin treatment for melasma so she can make the best recommendation for your wholistic treatment plan. Medications that worse the effects of melasma and/or cause photosensitivity can include certain antibiotics, cardiac medications, and others.
Thyroid Disease – For some patients with melasma, there is a co-morbidity with thyroid disease. For this reason, researchers believe that there could be a link between thyroid disease and melasma, such that those with thyroid disease are at a higher risk of developing melasma.
Are chemical peels good for hyperpigmentation?
Yes! Hyperpigmentation is defined as an area or patch of skin that is darker in pigmentation that the surrounding skin. Melasma is a specific form of hyperpigmentation that can occur on the surface of the skin. Chemical peels are extremely effective in lightening the affected area of skin in order to reduce hyperpigmentation by exfoliating the outer layer of skin and triggering cell turnover. The result is lighter, brighter, healthier-looking skin.
Which is better, laser or chemical peel?
Laser treatments can be used instead of or in addition to chemical peels to treat melasma. Dr. Green employs two types of lasers at her office: the Clear + Brilliant laser and the VBeam laser. These treatments work by exfoliating and resurfacing the skin, which removes the pigmentation and trigger’s the body’s production of new, lighter, brighter skin. When patients ask, which treatment is better, the answer is: it depends. Neither treatment process is inherently better than the other – it all depends on your unique physical goals and needs. When you have your initial consultation with Dr. Green, the two of you will work together to determine the treatment process that is best for you.
Are chemical peels safe for melasma?
Yes! Chemical peels are extremely safe and effective for eliminating and preventing melasma. That said, it is extremely important to consult with an expert dermatologist, such as Dr. Green, before receiving a chemical peel treatment. Usually, the side effects for chemical peels are mild – skin irritation at the treatment site that dissipates quickly. However, for patients with darker skin, some chemical peels can cause scarring or post-inflammatory hyperpigmentation. It is imperative to use a chemical peel that is safe and effective for all skin types.
Can melasma come back after a chemical peel?
It is possible for melasma to come back after a chemical peel treatment if you are exposed to harmful UV rays following the treatment. For that reason, it is very important to maintain strict sun avoidance following treatment. To do so, Dr. Green recommends wearing two types of sunscreen when you go outside: chemical sunscreen (which contains oxybenzone to absorb and transform the sun’s rays) and physical sunscreen (which contains zinc oxide or titanium dioxide to reflect the sun’s rays). You can also maintain sun avoidance by staying inside when the sun is at its peak intensity, between 10am and 2pm.
Chemical peel side effects
Chemical peels can improve the skin’s appearance. In this treatment, a chemical solution is applied to the skin, which makes it “blister” and eventually peel off. The new skin is usually smoother and less wrinkled than the old skin.
Chemical peels can be done on the face, neck, or hands. They can be used to:
- Reduce fine lines under the eyes and around the mouth
- Treat wrinkles caused by sun damage and aging
- Improve the appearance of mild scars
- Treat certain types of acne
- Reduce age spots, freckles, and dark patches (melasma) due to pregnancy or taking birth control pills
- Improve the look and feel of skin
Areas of sun damage may improve after chemical peeling.
After a chemical peel, skin is temporarily more sensitive to the sun, so wear sunscreen every day. It should say “broad-spectrum” on the label, meaning it protects against the sun’s UVA and UVB rays. Also, it should be a physical sunscreen and be above SPF 30. Limit your time in the sun, especially between the hours of 10 a.m. and 2 p.m., and wear a wide-brimmed hat.
Who Is a Good Candidate For a Chemical Peel?
Generally, fair-skinned and light-haired patients are better candidates for chemical peels. If you have darker skin, you may also have good results, depending upon the type of problem being treated. But you also may be more likely to have an uneven skin tone after the procedure.
Skin sags, bulges, and more severe wrinkles do not respond well to chemical peels. They may need other kinds of cosmetic surgical procedures, such as laser resurfacing, a facelift, brow lift, eyelid lift, or soft tissue filler (collagen or fat). A dermatologic surgeon can help determine the most appropriate type of treatment for you.
Before You Get a Chemical Peel
Tell your doctor if you have any history of scarring, cold sores that keep coming back, or facial X-rays.
Before you get a chemical peel, your doctor may ask you to stop taking certain drugs and prepare your skin by using other medications, such as Retin-A, Renova, or glycolic acid. The doctor may also prescribe antibiotics or antiviral drugs.
Work with your doctor to determine the depth of your peel. This decision depends upon the condition of your skin and your goals for treatment.
Ask your doctor in advance whether you will need to have someone drive you home after your peel.
How Chemical Peels Are Done
You can get a chemical peel in a doctor’s office or in a surgery center. It’s an outpatient procedure, meaning there’s no overnight stay.
The professional who does your peel will first clean your skin thoroughly. Then they will apply one or more chemical solutions — such as glycolic acid, trichloroacetic acid, salicylic acid, lactic acid, or carbolic acid (phenol) — to small areas of your skin. That creates a controlled wound, letting new skin take its place.
During a chemical peel, most people feel a burning sensation that lasts about five to ten minutes, followed by a stinging sensation. Putting cool compresses on the skin may ease that stinging. You may need pain medication during or after a deeper peel.
What To Expect After the Chemical Peel
Depending upon the type of chemical peel, a reaction similar to sunburn occurs following the procedure. Peeling usually involves redness followed by scaling that ends within three to seven days. Mild peels may be repeated at one to four-week intervals until you get the look you’re after.
Medium-depth and deep peeling may result in swelling as well as blisters that may break, crust, turn brown, and peel off over a period of seven to 14 days. Medium-depth peels may be repeated in six to 12 months, if necessary.
After treatment, you may need bandages for several days on part or all of the skin that was treated.
You’ll need to avoid the sun for several months after a chemical peel since your new skin will be fragile.
Possible Complications
Some skin types are more likely to develop a temporary or permanent color change in the skin after a chemical peel. Taking birth control pills, subsequent pregnancy, or a family history of brownish discoloration on the face may make that more likely.
There is a low risk of scarring in certain areas of the face. Some people may be more likely to scar. If scarring does happen, it can usually be treated with good results.
For people with a history of herpes outbreaks, there is a small risk of reactivating cold sores. Your doctor can prescribe medication to prevent or treat that.
Chemical peeling advantages and disadvantages
A chemical peel is a mixture of chemicals that forms gel-like consistency. It’s applied to the face in order to smooth the surface of the skin, remove the appearance of fine lines and remove blemishes. There are three types of chemical peels: mild, medium-depth and deep. Each have their advantages and serve different purposes.
What Are the Advantages of a Mild Chemical Peel?
- Chemical peels help to smooth dry skin
- Can help with pigmentation problems
- Controls acne
- Removes blemishes
- Less recovery time
- Helps with mild sun-damage
- Reduces mild blotchiness
- Fresher and younger looking appearance
What Are the Advantages of a Medium-Depth Chemical Peel?
- Thin facial lines are removed or the appearance is less noticeable
- The medium-depth reduces facial birthmarks
- The pigmentation in the skin is improved
- Helps with dry skin and old acne scarring
- Helps with sun-damaged skin
- Improves blotchy skin
- Younger looking overall appearance
What Are the Advantages of a Deep Chemical Peel?
- Ability to remove pre-cancerous growths
- Deeper acne scar emanation
- Long lasting effect
- Eliminates deeper lines on the face??
- Controls acne
- Helps with deep or course wrinkles
- Age spot removal
- Only a single treatment is necessary
- Smoother skin, younger appearance
- Long-term results are very good when the peel is specifically for acne scarring
The advantages of chemical peels are many, and all three help with different issues. The deep chemical peels are reserved for those with the worst types of skin problems, including serious acne, scarring and birthmarks. Some disadvantages of chemical peels need mentioning.
What Are the Disadvantages of a Chemical Peel?
- Excessive peeling normally happens more with the medium-depth peel and particularly with the deep peel
- Stinging sensation when initially applied
- Redness appears. Again, this is particularly so with the deep and medium peels. The light peel normally results in peeling like a sunburn.
- Temporarily may feel a bit of numbness
- Deep chemical peels can cause a crusting or scabbing after the treatment, as the deep dead skin cells are sleuthing off. This is temporary.
- Sensitivity to the sun ? you will need to stay out of the sun for a short time after the peel as your skin is more sensitive
- Costs can also be a disadvantage for some, since the average chemical peel cost $500 for each treatment
While some disadvantages do exist for chemical peels, the advantages do outweigh them particularly for those suffering from severe skin problems, such as acne or acne scarring. Even with the disadvantages, most people that have had them report they would have it again because of the overall improvement of their skin’s surface and the younger fresher look the entire chemical peels bring about. The discomforts often associated with a chemical peel are temporary and subside rather quickly.