What Melasma Looks Like

melasma

What is Melasma?

A skin condition presenting as brown patches on the face of adults. Both sides of the face are usually affected. The most common sites of involvment are the cheeks, bridge of nose, forehead and upper lip.

Who gets Melasma?

It mostly occurs in women, with only 10% of men being affected. Dark skinned races, particularly Hispanic, Asian, Indian and African American tend to experience it more than others due to the increase of melanin or pigment cells.

What causes Melasma?

The precise cause is unknown. People with a family history of melasma are more likely to develop it themselves. A change in hormonal status may trigger the condition. Melasma is commonly associated with pregnancy and also called chloasma or the “mask of pregnancy.” Birth control pills may also contribute or cause melasma, however, hormone replacement therapy used after menopause has not been shown to cause the condition.

Sun exposure is also a contributor. Ultraviolet light from the sun, and even very strong light from light bulbs, can stimulate pigment producing cells, or melanocytes, in the skin. People with skin of color have more active melanocytes than those with light skin. These melanocytes produce a large amount of pigment under normal conditions, but this production increases even further when stimulated by light exposure or an increase in hormone levels. Incidental exposure to the sun is mainly the reason for recurrences of the skin condition.

Any irritation or trauma to the skin may cause an increase in pigmentation in dark skinned individuals, which may also worsen melasma. It’s not associated with any internal diseasesor organ malfunction.

How is melasma treated?

While there is no cure, many treatments have been developed. Melasma may disappear after pregnancy, it may remain for many years or a lifetime.

Sunscreen is essential in the treatment of process. They should be broad spectrum, protecting against UVA and UVB rays from the sun. A SPF of 30 or higher should be selected. In addition, physical sunblock lotions and creams such as zinc oxide and titanium oxide are preferred as they do not protect the skin in a chemical way which may cause inflammation and exacerbate the condition. SPF should be worn daily, whether or not it is sunny outside or if you are outdoors or indoors. A significant amount of ultraviolet rays is received while walking down the street, driving in cars, and sitting next to windows.

A variety of lightening creams are available for treatment. These creams do not “bleach” the skin but rather decrease the activity of melanocytes, pigment producing cells.

Other medications which have been found to help are azelic acid, kojic acid, niacinimide and Vitamin C. You will have to talk to your Dermatologist or Aesthetician to know what is right for your condition.

Chemical peels, microdermabrasion and various laser treatments may help melasma. They should only be used by a medical skincare professional and in conjuction with a proper regimen for melasma specifically.

 

What’s the difference between all of the “Botox” brands?

types of botox

Different Types of Botox

At this point most people have heard of Botox, but did you know that this is just one of many different types of botox brands we call neuromodulators or neurotoxins?

Neuromodulators are the umbrella term for any product that utilizes botulinum toxin to temporarily relax a target muscle in order to prevent and sometimes treat fine lines and wrinkles. Botox has come to be the household name for neuromodulators, but other common brands include Dysport, Jeuveau, and Xeomin. What’s the difference between all of the brands or types of botox and which one is right for you?

Formulation

The biggest difference between brands is the form of botulinum toxin that is used- Botox is made of onabotulinumtoxinA, Dysport is abobotulinumtoxinA, Jeuveau is another form of botulinum toxin type A, and Xeomin is incobotulinumtoxinA. At the end of the day, all of these forms are effective in relaxing muscular contraction, so all will help to reduce the appearance of fine lines and wrinkles. However, there are some slight nuances that arise due to the different formulations.

Onset and Duration

According to the International Association for Physicians in Aesthetic Medicine (IAPAM), the average onset of Dysport is 3 hours, Botox is 72 hours, and Xeomin is 96 hours. In practice, most people notice the results of Dysport and Jeuveau within 3-7 days post injection, while Botox and Xeomin are typically noticeable after 1-2 weeks. For all products, dose = duration, meaning that the higher the dosage used, the longer the results can be expected to last (within reason). The average duration for most people is between 2-5 months.

Resistance

While rare, some people may develop a tolerance or resistance to neurotoxins due to the creation of antibodies. A person’s immune system may identify the ingredients used in these injections as being a foreign invader, so it responds by producing antibodies that neutralize their effect. While resistance can occur with any of these four types of injections, it’s most common with Botox and Dysport. Botox and Dysport contain additives that can “irritate” the immune system and, thus, trigger the creation of antibodies.

Xeomin, on the other hand, consists solely of botulinum toxin, so it’s less likely to cause resistance than its counterparts, however there still have been reported cases of tolerance to xeomin. This has led researchers to believe that it might be the actual botulinum toxin causing antibody formation instead of, or possibly in addition to the additives, however the jury is still out on that. All in all, only about 1 in 100 people who receive a neurotox injection will develop a resistance to it.

Dosage and Pricing

Dosage will vary from person to person, however you can typically expect that you will need 2-3 times the number of units of Dysport as you would with Botox, Xeomin, and Jeuveau. Botox is usually the most expensive per unit as you are paying for the brand, and Jeuveau is usually the most cost effective. Evolus, the company that produces Jeuveau, was able to achieve a lower price by focusing its FDA approval specifically on cosmetic applications for its product, whereas Botox is approved for both medical and cosmetic purposes.

At the end of the day, all four products are FDA approved and all work well to help reduce and prevent fine lines and wrinkles. Come in for a consult today to help decide which brand could be the right fit for you! types of botox types of botox types of botox types of botox

Crank Up the Collagen!

ultherapy
ultherapy

Collagen has now become the single most googled word, replacing “Botox”!

Collagen is everywhere: powders, pills, drinks, shakes, bars, you name it. And people are counting on some pretty miraculous results from these ingestable products. Don’t get me wrong, I like a good collagen peptide powder every morning in my coffee ( See post from 8/11/2020 ) but ingesting it can only do so much and may simply be a clean source of protein.

For those of us who are ready to really crank the collagen production into high gear and see changes in our skin, there’s Ultherapy treatment.

What is Ultherapy?

Ultherapy has been around since 2004 and continues to show impressive results. People often compare it to treatments such as Radio Frequency, Thermage and a multitude of different lasers.

While most of these treatments work by creating heat in the skin to stimulate collagen production, Ultherapy is the only device that allows us to see EXACTLY where we are placing the heat. It is also the only technology to get to the deepest depths of the dermis, a depth which can only be replicated in a surgical face lift.

Radio Frequency gets results by creating bulk heating, which we love but often times only stimulates certain types of collagen and some elastin and in a more superficial layer in the skin.

What makes Ultherapy so powerful is that it places very high heat at an extremly deep layer in the skin, a medium depth and a more superficial depth, depending on where the protein is needed most. Ultrasound technology allows us to see all of this and create a very specific, customized treatment for the individual.

Results do take 3-4 months to see but with little to no downtime, this treatment is worth the wait!

ultherapy
ultherapy

Exciting New Product Alert!

PCA Skin Vitamin b3 Brightening Serum - 1 fl oz

I’m certain we here at Accent Dermatology and Accent Aesthetics will always have our favorite, can’t live without skin-care products. So when something new comes along that we LOVE, it’s news worthy!

PCA Skin just came out with their Vitamin B3 Brightening Serum and we can’t keep it on the shelves!

This heavy hitter uses a 6% Niacinimide (A type of B Vitamin). Typically this ingredient has been used to reduce reds in the skin and help with acne. At a higher concentration of 6%, we are seeing not only a reduction in the reds caused by rosacea, acne, etc but also an excellent reduction in brown spots, photodamage and especially melasma!

This is an exciting new tool to add to anyone’s toolbox, especially those looking to reduce BOTH reds and browns and definitly breakout. It leaves the skin very hydrated and calm by strengthening it’s barrier function.

PCA SKIN Vitamin b3 Brightening Serum | LovelySkin

 

 

Retinoids vs Retinol: What’s The Difference?

Curious about the difference between Retinoids vs Retinol? This is an extremely common question, especially working with Dermatologists. Clients want to know if they should see the Dermatologist for a prescription or use something OTC (over the counter).

The Simple Difference

I like to keep it simple. The way I explain it to my clients is: Retinoids=Prescription strength, Retinol=non-prescription strength. All are Vitamin A. Now there is a lot of wiggle room here as there are a lot of different brands and concentrations out there.

Retinol Example

retinoids vs retinol

Retinoid Example

retinoids vs retinol

Retinoids vs Retinol Explained

A patient would see a Dermatologist for an Rx retinoid cream such as Tretinoin or Tazorac for conditions such as  severe acne, scarring, etc. These are converted to retinoic acid rapidly in the skin and begin the cell turnover process very fast. This is good for getting results quickly.

The downside of these can be, (for some, not all), extreme irritation and dryness. Because it works so quickly and strongly, it runs the risk of degrading the skins barrier function, leading to dryness, redness and overall intolerability. The problem with this is that a lot of clients will not use them consistently, which is crucial for improvement. For example: they will apply it Sunday night and become so dry and irritated for 2-5 days, then use it again once their skin has returned to normal. While this will still give a result, It is uncomfortable and not as efficatious.

Retinol on the other hand takes a bit more time to be converted into Retinoic acid in the skin but sometimes this is a good thing. Our favorite Retinol products from Revision Skincare are time released so the skin absorbs it in a very controlled manner, decreasing downtime and irritability. It also has several antioxidants including bakuchiol which is a broad spectrum antioxidant that increases the efficacy of the retinol, and contains several other antioxidants to help sooth the skin.

All of the Revision Skincare products contain peptides that do all sorts of things like help the skin hold on to precious moisture and help prevent loss of collagen and elastin, decrease inflammation, lighten hyperpigmentation, the list goes on and on. Revision has been a pioneer in the retinol business. Their products deliver prescription strength results but feel like a nuturing, luxury line.

Vitamin A derivatives are the ONLY product clinically proven to treat fine lines and wrinkles, so regardless of which one you choose, just use it! You will thank me later…

If you are unsure of which retinol to use, come in for a consultation. We are happy to find you the perfect fit for your skincare goals!

Retinoids vs retinol Retinoids vs retinol Retinoids vs retinol