Pigmentation Treatment – Tranexamic Acid Pigmentation treatment is one of the most common yet complex problems seen in the cosmetic industry. Hyperpigmentation is caused from injury, aging and hormonal problems (melasma) While it is exceptionally challenging and expensive to treat pigmentation successfully there is evidence that in a proportion of clients tranexamic acid tablets achieve excellent or good results. A consultation for pigmentation with Dr Charlson is £200. What is melasma? Melasma, also called ‘chloasma’ and ‘pregnancy mask’, is a common skin condition of adults in which light to dark brown or greyish patches of pigmentation develop mainly on facial skin. The name comes from melas, the Greek word for black. It is more common in women, especially pregnant women, and people with darker skin-types who live in sunny climates. However, it can also affect men (10% of patients) and any race. Melasma usually becomes more noticeable in the summer and improves during the winter months. It is not an infection therefore it is not contagious and it is not due to an allergy. It is not cancerous and will not develop into skin cancer. What causes melasma? The exact cause is not known, but several factors can contribute. These include pregnancy, hormonal drugs such as the oral contraceptive pill, and medical conditions that affect hormone levels. Sunshine and the use of sun-beds can make the tendency to melasma worse. Is melasma hereditary? No, although Melasma can be commoner in family members. What does melasma look like? Melasma appears as darker-than-normal skin affecting the cheeks, forehead, upper lip, nose and chin, usually in a symmetrical manner. It may be limited to the cheeks and nose or the skin of the jaw region. The neck and the forearms can also be affected. Areas of melasma are not raised. What are the symptoms of melasma? The cosmetic appearance of melasma can be upsetting and affect quality of life. Affected skin is not itchy or sore. How is melasma diagnosed? Melasma is usually easily recognised by the characteristic pigmentation and distribution on the face. Occasionally, your dermatologist may suggest that a small sample of skin (numbed by local anaesthetic) is removed for examination under the microscope (a biopsy) in order to exclude other diagnoses. Can melasma be cured? No, at present there is no cure for melasma, but there are several treatment options that may improve the appearance. If melasma occurs during pregnancy, it may resolve a few months after delivery and treatment may not be necessary. How can melasma be treated? Melasma treatments fall into the following categories, and can be used together: Avoiding known trigger factors, such as the oral contraceptive pill. Adopting appropriate sun avoidance measures and using sun-blocking creams. Skin-lightening agents. Chemical peels, dermabrasion and laser treatment. Skin camouflage. Sun protection Skin affected by melasma darkens more than the surrounding skin with exposure to sunlight, so sun-avoidance and sun-protection are important (see the ‘top sun safety tips’ below for more information).