California Health and Beauty


A New and Successful Treatment Option for Melasma

Unlike any other treatment available for melasma, Fraxel has proved to be the most successful for reducing or eliminating the skin condition known as the “mask of pregnancy.” Melasma appears symmetrically as hyperpigmentation and is usually triggered by a change in hormone levels. Melasma largely affects women with dark or ethnic skin tones and previously had no treatment that yielded fast and successful results.

One of the newest treatments for melasma that has been producing phenomenal results is the Fraxel laser treatment. The Fraxel laser delivers a series of tiny and closely spaced laser beams to the skin while simultaneously preserving normal healthy skin between the laser spots.

What is melasma?

Melasma is a skin condition that mostly affects adult women with ethnic skin tones, and is often triggered by a hormonal change. Only about ten percent of those affected by melasma are men.

In the United States, an estimated 6 million women suffer from this condition. Most commonly seen in Asian, Hispanic, Hispanic, Middle Eastern, and African women, melasma usually appears as patchy brown spots, typically on both sides of the face. It can appear across the nose, cheeks, forehead, and upper lip.

While the cause of melasma is still unknown, persons with a family history of melasma are more susceptible to developing the condition. Melasma is often triggered by a significant hormonal change like pregnancy and is sometimes called the “mask of pregnancy.” Birth control pills, sun exposure, and strong UV light exposure can also initiate the onset of melasma.

Melasma develops from the overstimulation of pigment producing cells in the skin, called melanocytes. Because people with darker skin naturally have more melanocytes, the occurrence of melasma is much higher for this group. When a person who is already susceptible to melasma is exposed to the sun, the skin reacts by producing an excess amount of pigment.

It is possible that melasma may disappear over time for some people. In some cases, however, it can remain for many years after its onset. If the melasma arrived with the beginning of a birth control pill cycle, it may be alleviated by discontinuing the medication.

The most important weapon for preventing melasma is sunscreen. For those who have already developed melasma, it is crucial that sunscreen is worn all the time to prevent any kind of accidental exposure to UV light.

The FDA approved the Fraxel laser for the treatment of melasma in July of 2005. The Fraxel Laser works through a new laser technology called “fractional resurfacing.” Fractional resurfacing technology (Fraxel) allows only a fraction of the layer of skin to receive the laser light.

The laser delivers a series of microscopic closely spaced laser spots to the skin while simultaneously preserving normal healthy skin between the laser spots. This preservation of healthy skin results in rapid healing following the laser treatment. The entire face can be treated with the laser in approximately 30 minutes.

Aside from Fraxel, there are several other types of treatment are available for melasma. Assessment by a dermatologist will help you determine which method will be effective.

Bleaching creams do not technically “bleach” the melanocytes, but cause a decrease in activity of these pigment-producing cells. If you have only mild melasma, try for an over-the-counter cream first. These creams contain low concentrations of hydroquinone, which is a widely used depigmenting agent and is often effective for mild melasma when used twice daily.

With any of the creams, it takes about three months to see an improvement in melasma. With more severe cases, a dermatologist may prescribe creams with higher concentrations of hydroquinone. Other ingredients which may enhance the bleaching effect of the creams are tretinoin, steroids, and glycolic acid. Sunscreen is essential and comes combined with the bleaching cream in some products.

Two other medications which have been found to help melasma are azelaic acid and kojic acid. It is important to follow the directions of your dermatologist carefully in order to get the maximum benefit from your treatment regimen and to avoid irritation and other side effects.

Other treatments which may or may not help in the treatment of melasma include chemical peels, microdermabrasion, and IPL, but results have not been consistent.

Thomas Shelton Powers, MD

Thomas Shelton Powers, MD received his undergraduate degree at Centenary College in Louisiana with high honors majoring in advanced Chemistry.

He received a National Institute of Health Scholarship to study Pharmacology at Tulane University Medical School, and later received his medical degree from the University of Texas-Southwestern Medical School in Dallas, Texas.

After residency at the University of Miami-Jackson Memorial Hospital, he served as Commander and Emergency Medical Officer on the front lines in Vietnam, with the 3rd Marine division of the U.S. Navy. Dr. Powers practiced emergency medicine in San Francisco, California until 1998, where he served as President and CEO of Medicus Medical Group, one of the largest emergency physicians group in the nation.

Dr. Powers was one the the early pioneers in cosmetic laser medicine. He was certified in advanced cosmetic laser procedures with Dr. Patrick Bitter, Jr. founder of the FotoFacial RF™ procedure. He has completed training in Botox®, and IPL with Dr. Jean Caruthers on the Luminis laser. He went on to serve as Medical Director for four laser skincare clinics in California. He is active in training health care professionals in aesthetic medicine. Dr. Powers limits his practice to only safe FDA approved, highly effective, low down time procedures such as laser hair removal, laser IPL™ fotofacial and body rejuvenation treatments, Botox®, and Cosmoplast®.

He has also developed the “20 minute face lift” a combination of Botox® for upper face, and Cosmoplast® for the lower face, cheek and lip. “Although you can get Botox® and collagen just about anywhere these days, it’s the expertise, skill and placement that gives you the most natural, longest lasting result”, according to Dr. Powers, who is known for his 20 minute face lift.

“I can make you look younger and more vibrant with the proper placement of Botox® for the top portion of your face and a dermal filler to the bottom half to fill the lines and creases giving you a more youthful look in 20 minutes,” says Dr. Powers.

He is committed to staying on the educational forefront of cosmetic medicine, through his affiliation with numerous medical associations, including the American Association of Lasers in Medicine and Surgery, the International Association of Aesthetic Medicine, and the International Society of Cosmetic Laser Surgeons. Dr. Powers is also a member of the Botox Cosmetic Physicians Panel and the American Medical Association.

Dr. Powers currently is the Medical Director for Diva Aesthetic Medical Group where he oversees 3 Orange County locations.

Thomas Shelton Powers, MD
2054A Westminster Mall
Westminster, CA