Treating melasma, chloasma and post-inflammatory hyperpigmentation

Treating melasma, chloasma and post-inflammatory hyperpigmentation 

The histological features of melasma and chloasma are discussed elsewhere in this book. The standard recommendations for treatment often only mention topical applications of tretinoin, hydroquinone and other tyrosinase inhibitors corticosteroids and peels are considered as a last resort because of their potential to turn melasma into post-inflammatory hyperpigmentation (PIH). Conventional peels require conscientious pre-peel preparation to avoid this danger. Easy TCA (ETCA), in combination with appropriate post-peel care, can be used to treat melasma without the constraints of pre-peel preparation (Eigures 16.1-16.5). 

It is not usually necessary to prepare the skin, but with long-standing or resistant melasma or with a skin phototype higher than Fitzpatrick IV, preparing the skin can be worthwhile and can improve results  

Melasma on the neck The position might suggest poikiloderma of dvatte, but there are neither telangiectasias nor any atrophy of the skin around the follicle. 

Melablock HSP 50-i- (see Chapter 3) applied aU over the face in the morning and then reapplied every 3 hours on the melasma itself 

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