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Pigmentation Issues

Skin discoloration and spots are a major problem for many people and may be related to genetics, sun damage, or hormones. Genetic spots are often deep in the dermis and require procedures and topical treatment for removal. Examples of dermal pigmentation include Nevus of Ota, Nevus of Huri, and dermal melanosis. Dermal pigmentation is common in some ethnicities and rarely seen in others.

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Examples of Skin Discoloration Caused by the Sun

Discoloration caused by the sun can appear as small round spots, or large patches of discoloration, which are occasionally accompanied by broken veins in the affected area. Examples of discoloration from the sun include freckles or Lentigo solaris. Discoloration from the sun is usually seen on sun-exposed areas of skin, such as the face, arms, neck, chest, and legs.

Melasma: Skin Discoloration Caused by Hormonal Imbalance

Hormonal pigmentation, called melasma, often occurs in women who possess a genetic predisposition to the condition. For some, melasma can be a progressive, long-term problem and there is no cure. However, most melasma can be treated, and pigmentation resolved, but there is always the chance that the pigmentation may return.

Melasma is treated topically, with superficial melasma responding well to creams and disappearing, as compared to deep melasma, which requires procedures for treatment. Procedures used by Dr. Zein Obagi to treat melasma include a combination of depth-controlled peels and/or laser procedures.

For Maximum Effectiveness, Treat the Entire Affected Area

To treat melasma effectively, Dr. Zein Obagi recommends treatment over the entire affected area, not just the dark spots.

It is common for the first 6 weeks of treatment to experience redness, dryness and peeling when beginning the ZO® system.
Melasma often masks broken capillaries, so once the pigment is resolved, it is not uncommon to see capillaries where pigment was once seen. Visible capillaries are easily masked with one or more laser treatments.

Conditions That Make Melasma Worse and More Difficult to Treat

Exacerbating conditions that can aggravate melasma include oily skin, rosacea and acne. When treating melasma, conditions like these must be addressed and treated simultaneously.

The Ideal Protocol for Treating Melasma

Attempting to treat melasma with lasers or peels is not recommended unless skin has first been properly stabilized and conditioned. In his practice, Dr. Zein Obagi uses ZO® Medical therapeutic solutions and ZO® Skin Health daily skincare products to accomplish this. Lasers and peels may make melasma worse and more difficult to treat if underlying skin health isn’t properly addressed prior to beginning procedures.

Dr. Zein Obagi believes that bleaching agents alone are not sufficient to effectively treat melasma, making over the counter products ineffective for treatment. Medical supervision with a specialized treatment program is recommended to effectively treat melasma.

Avoid These Melasma Triggers

Hot water, steam rooms and saunas are not good for the skin, especially when treating melasma, and are best avoided.
Sun protection is essential when treating melasma, as sun exposure can trigger abnormal pigmentation.

Delay of Treatment May Result in Skin Damage

Skin Disease requires medical consultation and proper treatment from a qualified health care professional or dermatologist. Delay of treatment may result in skin damage. If you have any skin care concerns, or have used over-the-counter products for more than one month to treat a condition and have seen no improvement, Dr. Zein Obagi recommends you seek medical care.

Please call or click to schedule a personal evaluation of your pigmentation issues. The staff at the Obagi Skin Health Institute is highly trained in treating melasma.

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