Pigmentation

Pigmentary disorders

Vitiligo

This is not an uncommon condition and can be socially crippling. At times it can be a condition that is difficult to treat. Using evidence-based medicine and best practice principles we will endeavour to provide you with the best treatment plan which can involve creams, phototherapy and in certain circumstances laser treatment. Cosmetic camouflage advice and consultation with my cosmetic nurse is also available.

Chloasma

This condition is also known as melasma and is a common cosmetic condition. Women are particularly bothered by this condition. It may be aggravated by hormones such as taking the oral contraceptive pill and pregnancy but often there are no underlying factors other than skin type and our sunny weather.

Treatments include prescription and non-prescription retinoids, niacinamide, kojic acid, hydroquinone aid in skin lightening. A series of very superficial peels with alpha hydroxy acid AHA (20-40%) or salicylic acid SA (10-15%) to promote penetration of hydroquinone into the deeper epidermal layers may be effective in patients with more epidermal pigmentation. About 5 to 6 peels are done every 2-4 weeks over 3-6 months. For a more immediate improvement a trichloroacetic acid TCA (10-15%0 peel can be done in conjunction with a series of SA or AHA peels. More extensive chloasma may require medium-depth chemical peels using Jessner’s solution and 35%TCA. Hydroquinone is applied twice daily between chemical peels. Using a broad spectrum sunscreen SPF 50 with at least 2mg/cm2 as well as a broadbrim hat and sunglasses are strongly recommended.

Chloasma seldom responds to laser and IPL. However in selective cases Er:YAG laser may be effective.