Melasma, a condition causing darkened discoloration on the skin, can affect anyone at any age. Melasma usually appears as dark spots or patches on the nose, upper cheeks, lips and forehead, but can show up anywhere that skin has been exposed to the sun. Also known as the mask of pregnancy because of the condition's tendency to afflict pregnant women, the spots are often a result of increased female hormones in the body and overexposure to the sun.

Treatment Options

There are many different options for treating melasma. Some people opt to use topical creams such as hydroquinone or Retin A. But, the most effective method of combating the condition is a chemical skin peel. Like many things in life, though, not all chemical peels are created equal, and the more intense and painful the peel, the greater the results.

Who Treats Melasma?

Some peels can be done by an esthetician for less money, but the most powerful peels can only be performed by a licensed dermatologist. Be aware that a series of peels is often necessary to achieve the most prominent results, although even after one peel a difference in skin texture and tone should be noticed.

Understanding Chemical Peels

Chemical skin peels are performed using a chemical solution applied directly to the skin to burn away dead cells and allow the newer, fresher skin to form. They can be used to treat anything from melasma to fine lines and wrinkles to cancerous skin growths. The most commonly used chemicals are Phenol, trichloroacetic acid (TCA) and alphahydroxy acids (AHAs). Usually the doctor measures out a precise formula for the specific needs of each patient.

Mild Peels

A mild peel usually utilizes a solution containing alpha-hydroxy acids which includes glycolic adic and is the least intense of the chemical peels. It will brighten dull skin and dull the appearance of melasma. Usually applied in 15 to 20 minutes, it involves minimal pain. Skin takes about two days to a week to recover from some swelling, redness and peeling. New skin has a more even appearance, and dark spots, depending on their intensity to begin with, will have lightened. Since this is the weakest form of peel, its results are not as long lasting as the others, and may require many treatments to completely lessen the appearance of melasma.

Medium Peels

Medium peels most commonly use Trichloroacetic acid (TCA) and cause second-degree burning of the skin. There may be more intense pain during application than during a mild peel, and the recovery time is longer with greater redness, peeling and swelling. It usually takes a few more days of recovery than with an alpha-hydroxy acid peel but the results on the effects of melasma are also greater and a bit more long-lasting.

Intense Peels

Intense peels use phenol and also cause second-degree burning of the skin. This peel penetrates several layers of facial skin and provides the most noticeable and long-lasting results. Unfortunately, not only do you get the most pain for your gain, there are also risks involved. This type of peel is usually not performed on people with darker-colored skin because it could permanently lighten all the skin on the face.

Which Is the Best?

All of the peels work to some degree to minimize the appearance of melasma and restore more even pigmentation. Time available for recovery, the amount of pain willing to be tolerated and how quickly results are required all need to be weighed when making a decision about which peel should be used to treat melasma.