Sun exposure increases the degree of pigmentation. The darker pigmentations occur over bony prominences of the forehead and cheekbones which receive higher solar radiation.

Melasma is most commonly seen during pregnancy when patient takes contraceptives, but also it can show up during menopause and also on male persons.

Histologically.
We observe increased melanin. Especially in the basal membrane with normal melanocyte quantity Histologically it is difficult to distinguish nevus latte, Freckles, Albright syndrome or Addison's disease.

Clinicopathologic correlation.
Increased estrogen and progesterone stimulates the melanocytes to increase their production of melanin.

Treatment of melasma.
1) Suspension of contraceptives.
2) Adequate physical and chemical light protection.

Many of the treatments performed to date such as ablative laser, dermabrassion, peeling, skin lightening creams etc. Fail or exacerbate dark pigmentation of the skin irritative phenomenon.

The most modern and effective treatment to date for the treatment of this resistant and recurrent pigmented lesion is the Diffractive Micro Fractional Nd:YAG Laser HELIOS II.

Treatment video

Helios II
Is a Diffractive Micro fractional laser technology combing the strengths of a true Q-switched Nd: YAG laser with Diffractive Optical Elements (DEO).
Such combination and its use in dermatologic applications was devised and patented back in 2009 by Laseroptek CEO, Prof. Hong Chu.

Diffractive Micro Fractional technology takes advantage of converting a large area spot and converts it into 81 micro columns, each having exactly the same peak power and fluency solving at the same time the need for higher penetration and also the need for less recurrence of collateral damage that are so common in other systems.

Helios II is specially designed for melasma and all kinds of pigmented lesions that occur throughout the year on all skin types, even in dark and tanned skin.
The light energy from the Helios II in 1064nm Q-switched mode impacts the pigmented lesion deeply without irritating the skin, it is essential to treat all kinds of pigmented lesions such as post inflammatory hyper pigmentations, solar lentigines, etc.

While many pigmented lesions in hand and face are removed in a few sessions, the same is not so easy with melasma which takes an average of 5-10 sessions with intervals of 15 days in between to achieve remission or part thereof.

This treatment must always be accompanied with photo protection