Melasma is a skin condition presenting as brown patches on the face of adults. It is thought to be the stimulation of melanocytes, or pigment-producing cells, by the female sex hormones estrogen and progesterone to produce more melanin pigments when the skin is exposed to sun.
The causes of Melasma can be
1. Sun exposure. It is believed that this is the most important causes of melasma. Ultraviolet light from the sun, both UVA and UVB, can stimulate pigment-poducing cells.

2. Hormones. A change in hormonal status may trigger melasma. It is commonly associated with pregnancy and called chloasma. Birth control pills may also cause melasma.

3. Pharmaceuticals. Patients who take certain medicines such as anticonvulsants may have brown patches on the facial skin.

4. Cosmetics. Irritation and allergic reaction to coloring or aroma ingredients in cosmetics can cause melasma, but this is quite rare.

5. Heredity. Family history and melasma maybe related because melasma is found more in Asian people than in Caucasians. However, this observation may not be from heredity but may be from the environment or sunlight.

Treatments of Melasma
The principle in the treatment of melasma is finding the cause, correcting the cause and avoiding the cause. For example, if melasma is caused by the consumption of birth control pills, then you should seek the doctor’s advice to change the birth control method. Good and efficient sunscreens are essential in the treatment of melasma. Avoid sunlight as much as you can. A variety of bleaching creams are available for the treatment of melasma. The important ingredients can be hydroquinone, Vitamin A acid, corticosteroid, azelaic acid, etc. It is important to follow the directions of your dermatologist carefully to get the maximum benefit from your treatment regimen and to avoid irritation and other side effects. Do not buy medicines by yourself and use them over a long period of time because the side effects may make you look worse. Other treatments such as chemical peels, microdermabrasion, iontophoresis, and laser surgery may help melasma, but results have not been consistent.

One of the most important question is can melasma be completely cured after treatment?

The answer is it depends on the cause and the type of melasma.

For example, melasma caused by the consumption of birth control pills or pregnancy will slowly fade away after one stops taking the pills or after the baby is born. Some patients may have persistent melasma because of causes such as sunlight. If these causes cannot be corrected, melasma will persist over a long period of time. “Shallow” melasma will response better to treatment than a “deep” melasma. After treatment and the facial skin is better one should strictly avoid the irritants, especially sunlight, and constantly apply an efficient sunscreen to prevent the recurrence of melanoma.

Facial wrinkles can have various causes such as stress, sunlight, dry and undernourished skin, and the decrease of collagen and elastin under the skin because of increasing age.
Treatments
There are many ways to treat wrinkles, depending on the type.

1. The application of nourishing cream to increase the skin moisture-this treatment is suitable for those with dry, undernourished skin and shallow wrinkles.

2. The use of IPL or high-intensity light, E-MAX, or Thermage. These treatments activate the production of collagen under the skin and make the skin firm and refreshed. This method should be under careful specialist observation to make sure the equipment selected is suitable to the skin condition and the patient’s problems.

3. Botulinum Toxin or Botox – Botox blocks the chemical signals that cause muscles to contract. When the muscles cannot tighten, the skin flattens and appears smoother and less wrinkled. Botox works well on frown lines between the eyebrows and across the forehead, and crow’s-feet at the corners of the eyes.

4. Hyaluronic acid – Soft tissue fillers, such as hyaluronic acid, can be injected into deeper wrinkles on the face. They plump and smooth out wrinkles and furrows and give the skin more volume. This is suitable for wrinkles that occur even without muscle movement such as the cheek furrows, the wrinkles on the lips, or the wrinkles remaining after Botox injection.