Melasma epidermal

The safety and efficacy of a series of glycolic acid facial peels were investigated in 25 Indian women with melasma [16]. Patients were treated with 50% glycolic acid peels monthly for 3 months. Improvement was noted in 91% of patients with maximal clearing occurring in patients classified with epidermal melasma. Side effects were observed in one patient who developed brow hyperpigmentation. 

Epidermal melasma mcreased melanin in the basal, suprabasal and stratum corneum layers. Clinically, melasma... 

Histopathology this classifies melasma in epidermal, dermal and mixed. 

It is commonly accepted that epidermal melasma is more responsive to therapy due to its superficial distribution. 

Purely epidermal there is a lot of melanin in the basal and suprabasal layers of the epidermis. It is occasionally found throughout the epidermis. A Wood s light increases the contrast between the melasma and normal skin. This is the most common type of melasma. 

If the frosting on the melasma is pink and even, with some epidermal sliding, the ETCA solution should not be applied there again. 

Ejaz A et al (2008) Comparison of 30% salicylic acid with Jessner s solution for superficial chemical peeling in epidermal melasma. J CoU Physicians Surg Pak 18 205-208... 

Indeterminate - melasma in skin phototype V-VI By Wood s lamp (365 nm), enhancement of pigment is only seen in the epidermal type [68,98,126]. Thongh it may determine the depth of melanin in the skin, it is not useful for phototypes V-VI [50]. Sanchez et al. [127], in his study, classified melasma using Wood s lamp into Epidermal (70%) - enhancement or accentuation of color contrast between affected and normal skin (most common)... 

Topical indomethacin was shown to be effective for epidermal type melasma particularly on the cutaneous upper lip of women [117]. In the author s experience, a study done on 48 Filipino women with epidermal and mixed melasma showed that 8% topical indomethacin applied twice daily for 12 weeks on melasma areas was effective and safe, with a significant difference on... 

It is one of the most frequently used superficial peeling agents for epidermal melasma. 

Combined peel using salicylic acid 25% in alcoholic solution and TCA 10% gel, in 3-4 settings at 4-5-week intervals, showed regression of epidermal melasma with no relapse even after 6 months post peels significant pigmentation reduction was noted in cases of mixed melasma. With the absence of inflammatory reaction that may lead to PIH, it is safe for patients with darker skin phototypes [143]. 

Combined with topical therapy (5% ascorbic acid), results were superior compared to TC A alone in treating epidermal melasma [136]. TCA 35% applied in conjunction with GA or Jessner s solution achieves a midlevel peel, with healing time between 7 and 10 days [9,25]. 

But in the author s experience on two different studies, using vitamin C or tretinoin 0.1% gel iontophoresis, the Filipino women with epidermal and mixed melasma obtained lightening of their pigmentation whether they were in the treatment or placebo group [54, 55],... 

Using a mid-infrared 1,550 nm laser produced a low incidence of pigmentary changes associated with traditional resurfacing techniques. There was minimal downtime and erythema. For daiker skin patients with epidermal melasma, long-pulsed 532 nm QS laser and the nonablative 1,540 nm CO laser may prove safer and efficacious, with care in the choice of fluence and spot size [126]. 

Inflammatory linear verrucous epidermal nevus Melasma... 

Ejaz A, Raza N, Iftikhar N, Muzzafar F. Comparison of 30 % salicylic acid with Jessner s Solution for superficial chemiced peeling in epidermal melasma. J Coll Physicians Suig Pak. 2008 18 205-8. 

Topical methimazole is used as a skin depigmenting agent for conditions that include epidermal melasma. In 20 patients who used this treatment once daily for 6 weeks there were no significant changes in circulating thyroid hormone or thyroid-stimulating hormone (TSH) and no significant cutaneous adverse reactions [33 ]. 

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