Hyperpigmentation History and Scope

Hyperpigmentation, which is also known as melasma, is a common aesthetic concern for many. Typically prescribed topical creams for melasma are hydroquinone alone or in combination with tretinoin. However, some patients report sensitivities with use of hydroquinone, as well as with tretinoin. Additionally, hydroquinone use is not advised during pregnancy. An alternative and effective treatment for melasma that is also safe during pregnancy is a combination of Cloud Vitamin Cream’s Silymarin cream, Vitamin A Cream, Vitamin B3 Cream and sunscreen. 

Melasma, a type of hyperpigmentation, is often reported as an aesthetic skin concern. The American Academy of Dermatology (AAD) describes melasma as follows:  “It causes brown to gray-brown patches on the face. Most people get it on their cheeks, bridge of their nose, forehead, chin, and above their upper lip.” This excess production of melanin sometimes looks like large splotches of freckles and can even cover entire areas with a brownish, uneven skin tone. The AAD goes on to add that, “Women are far more likely than men to get melasma. It is so common during pregnancy that some people call it the mask of pregnancy. Hormones seem to trigger melasma.” Treating melasma during pregnancy can be difficult, as both hydroquinone and tretinoin are not advisable to use during pregnancy. 

In addition to hormonal changes, melasma is also caused by sun exposure. The sun produces the four types of rays:  UVA, UVB, IR, or infrared rays and VIS, or visible rays. UVA rays cause ageing (loss of elasticity, fine lines and wrinkles), UVB rays cause sunburns, IR, or infrared rays, create heat that makes it warmer when the sun is out and VIS rays create the light that you see from the sun. An article titled, “Melasma:  A Comprehensive Update” reported that, “Several studies have shown that light from both ultraviolet (UV) and even the visible spectrum can induce pigmentary changes in the skin, including Fitzpatrick skin phototypes IV to VI.” Since the sun’s rays are 50% infrared rays, 43% visible rays and 7% UV rays (UVA/UVB) and sunscreen only blocks UV rays, by simply wearing sunscreen and no other protection, we have ignored the other 93% of the sun’s energy. By no means do we recommend discontinuing sunscreen use! We do, however, encourage sunscreen use with the addition of ingredients that provide sufficient protection form a wider range of the sun’s rays.

Cloud’s approach to treating melasma is a comprehensive regimen that includes an effective sunscreen, Vitamin A Cream, Vitamin B Cream and Silymarin Cream. This regimen includes ingredients that will act as antioxidants to protect the skin, as well as ingredients that will block the sun’s harmful rays, which will both help to prevent new hyperpigmentation from forming. Cloud’s regimen also includes ingredients that will brighten and even skin tone, which helps to reduce already existing hyperpigmentation, or melasma. Since melasma is difficult to treat and can be very stubborn, we recognize that a multiple, simultaneous approach involves counteracting many different elements. 

First and foremost, applying a broad spectrum sunscreen every day is critical. An example of a reliable sunscreen is Ombrelle SPF 60. Sunscreen protects the skin from UVA rays, which can cause premature ageing, and also UVB rays, which are the rays that cause a sunburn.

Secondly, though retinoids like tretinoin have always been a mainstay in melasma treatment, they require a prescription and can also be very irritating to the skin. An alternative is Cloud’s Vitamin A cream. Vitamin A cream’s main ingredient is retinyl palmitate, which is in the same family as tretinoin, but is much more easily tolerated. Vitamin A cream acts as a sunscreen as well as an antioxidant and has the equivalent protection of an SPF of 23. Additionally, it also offers the benefits of a retinoid, such as reduction of fine lines and wrinkles as well as increasing cell turnover, which helps to reduce the appearance of melasma. The retinyl palmitate in Vitamin A cream also reduces sun toxicity by 90%. 

Thirdly, Silymarin is a product that acts as a sunscreen and a highly potent antioxidant and also works to prevent cancer. It is important to protect the skin with a sunscreen and antioxidants. Adding Vitamin A cream and Silymarin cream under your sunscreen will give the skin a broader range of defense. The reason they are both needed is because they work differently to protect the skin. The sunscreen works from the outside and blocks some of the sun’s harmful rays. It helps to provide a veil of protection, but it does not block the full spectrum of the sun’s rays. An article called “Photoprotection of human skin beyond ultraviolet radiation” stated that, “It is now generally accepted that ultraviolet (UV) B (290 – 320 nm) and UVA (320 – 400 nm) radiation are casually related to photocarcinogenenesis”. The article further stated that, “wavelengths within the visible (VIS) (400 – 770 nm) as well as the infrared (IR) spectrum (770 nm – 1mm) range, significantly contribute to the photoaging of the skin.” Keeping that range in mind, it is important to know that sunscreen only protects the skin to a depth of 320nm – 380nm, depending on the type of sunscreen that you use. Additionally, an article titled, “Melasma:  A Comprehensive Update”, stated that, “Ultraviolet light and visible light can induce melanin formation.” Fortunately, Cloud’s Vitamin A cream and Silymarin Cream are able to protect the skin to a greater depth than sunscreen alone, so partnering them with sunscreen gives the skin full protection.

Antioxidants, like Cloud’s Vitamin A cream and Silymarin cream, work by penetrating the skin and thus are able to go deeper to protect the skin, acting as key components in complete sun protection. In an article from the “Journal of Drugs in Dermatology” titled “Vitamin A and Its Derivatives in Experimental Photocarcinogenesis:  Preventive Effects and Relevance to Humans” reported that, “Based on experimental data, and more importantly on human data, the authors of this paper suggest that the addition of RP to skin care products provides a protective effect against damaging UV radiation.” Retinyl palmitate, or RP, is also known as vitamin A. Retinyl palmitate works to filter the sun’s rays and is the main ingredient in Cloud’s Vitamin A cream. 

Lastly, Cloud’s Vitamin B3 cream is the fourth step in Cloud’s treatment regimen for melasma reduction. Vitamin B3 cream’s main ingredient is niacinamide, or vitamin B3. It has independently been shown to improve epidermal function and has the ability to even skin tone, thus reducing hyperpigmentation, or melasma. As an added bonus, Dr. Oz referred to niacinamide as, “Botox in a bottle”, because of its ability to diminish fine lines and wrinkles and give the skin a smoother appearance. 

Melasma is a common and often frustrating skin care concern. Treating melasma is a challenge and it can be difficult to know where to begin and what methods will be most effective. We realize many patients are struggling with hyperpigmentation and have used other products or professional treatments with little or no success. In cases of very hard-to-treat melasma, hydroquinone can be added into Cloud’s melasma homecare regimen. For many, Cloud’s core treatment products are effective without the addition of hydroquinone. We strongly encourage patients concerned about melasma to try Cloud’s comprehensive melasma regimen, which includes a combination of Cloud Vitamin Cream’s Silymarin cream, Vitamin A Cream, Vitamin B3 Cream and sunscreen. We have found that after consistent usage of Cloud’s combination treatment for at least three months, many patients find improvement in their melasma.

November 04, 2014 by Cathy Mohr
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