Dr Sotirios Foutsizoglou

Medical Director | London

Pigmentation Disorders
Pigmentation disorders usually manifest as patchy skin discoloration with
irregular borders mainly affecting face, neck, decolletage and hands.

About • Other aggravating factors include certain

cosmetic products e.g. exfoliating lotions
Melasma (or Chloasma when present during and bleaching agents especially when used
pregnancy) is one of the most common without sun protection, a wide range of
pigmentation disorders. medication such as corticosteroids, systemic
retinoids or other systemic photosensitizing
It presents as patches of skin discoloration drugs such as certain antibiotics.
developing gradually over time. Most often
it manifests as changes in the colour of Skin colouring
pigmentation of the face mainly affecting cheeks,
forehead and nose. Melasma can cause sufferers Melanin, apart from being an excellent
psychoemotional distress and interfere with photoprotectant, is also the primary determinant
normal social interaction as people may feel self- of skin colour. There are two types of melanin;
conscious of their uneven skin tone. eumelanin and pheomelanin The enzyme
tyrosinase is required for melanocytes to produce
The skin disorder affects primarily women and all melanin from the amino acid tyrosine.
skin types can be affected but melasma is more
common in darker skin complexions. Indications
Various factors have been associated with Dr Sotirios Foutsizoglou has been using
melasma. Some of them include: over a number of years the Dermamelan
Depigmentation Treatment by Mesoestetic with
• Genetic predisposition
very good results indeed. Dermamelan is a safe
• Hormonal causes such as pregnancy, treatment for all skin phototypes (Fitzpatrick I – VI,
contraceptives, stimulation for I.V.F. see table) and it can be used for a variety of skin
blemishes including
• Exposure to sun can trigger or may act as an
aggravating factor for melasma. • Melasma (all types)

• Post Inflammatory Hyperpigmentation (PIH) • Freckles

secondary to ordinary conditions such as
• Solar lentigo (eg, actinic lentigo, senile
acne or injury to the skin resulting from
lentigo, sun spot, liver spot)
sunburns, surgery or cosmetic procedures
such as chemical peels, dermabrasion, lasers • Juvenile lentigo
and cryotherapy (liquid nitrogen treatments).
• Post-inflammatory hyperpigmentation
• Thyroid and Addison’s disease.

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 Dr Sotirios Foutsizoglou
Medical Director | London

• Idiopathic hyperpigmentation Dermamelan is performed in 2 stages:

Dermamelan can also help in hypomelanoses Stage 1
such as pielbadism, vitiligo and pityriasis alba
causing a more even distribution of the remaining • Dermamelan should be used by experienced
pigment. healthcare professionals who can make
an accurate diagnosis of the patient’s skin
Dermamelan is a well tolerated non-hydroquinone problem. For instance there are a number
depigmentation treatment which acts as a of skin conditions that mimic melasma
reversible tyrosinase inhibitor without damaging or pigmentation disorders such as Riehl
the melanocytes; that means less likely to cause melanosis, Poikiloderma of Civatte, drug-
post treatment patchy hypopigmentation. induced pigmentation, inflammatory diseases
(e.g. lupus erythematosus, atopic dermatitis),
Dermamelan’s active depigmenting ingredients skin cancer, etc. Therefore a correct diagnosis
are Kojic Acid, Phytic Acid, Alpha Arbutin and is of paramount importance.
Azelaic Acid .
• For mild hyperpigmentation the Dermamelan
Dermamelan combines alpha and beta hydroxy degreasing solution (included in the
acids, that help with the excess melanin Dermamelan pack) is applied as skin prepping
elimination, with a vitamin complex (e.g. Vitamin to aid ingredient penetration.
C and E) and sunblock filters (e.g. avobenzone) For moderate to severe hyperpigmentation
providing a very effective antioxidant protection. Dr S. Foutsizoglou also uses 50% Mandelic
It also stimulates collagen production and cell Acid which has both keratolytic and whitening
renewal enhancing skin luminosity. properties enhancing the action of the
Dermamelan’s active ingredients.
If you are interested in knowing more about
Dermamelan and other depigmentation • Finally the Dermamelan Mask, with the active
treatments contact us today to book your free ingredients, is applied and advised to be left
consultation. on the face for

Treatment Explained • 8 hours for phototypes I –II (Pale skins)

Dermamelan can be used in any time of the year • 10 hours for phototypes III–IV(Mediterranean
provided that a high SPF sunscreen is applied type of skin)
during the day for optimal results.
• 12 hours for phototypes V-VI (Asian and Black
There is no special preparation for Dermamelan. skin)
However patients must have not used topical or
oral steroids, retinoids or other photosensitizing If used in other parts of the body shorter duration
medication such as certain antibiotics within the of application is normally required.
previous 3 months. Dermamelan should not be
used in conjunction with other ablative modalities Stage 2
such as lasers, microdermabrasion, other
bleaching agents or TCA peels. • On completion of application time the patient
can remove the mask with soap and water.

• Maintenance is achieved by using the

Dermamelan Treatment cream for up to nine
months depending on the severity of your skin
problem.

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 Dr Sotirios Foutsizoglou
Medical Director | London

• Application of the Dermamelan Treatment occasionally up to 1 year. This will be discussed

cream is recommended for 3 times a day for during your first consultation.
the 1st month; twice a day for 2nd and 3rd
months; and once at night time thereafter.
In addition to Dermamelan Treatment cream,
In severe cases stages 1 and 2 can be repeated
used as part of the maintenance protocol, patients
in 15 days time.
are also advised to use:
For localised hyperpigmentation:
• Vitamin C 20% twice a week on face and
Mesoestetic Melanogel Touch can be applied neck.
twice a day directly onto the skin blemishes in
order to accelerate the lightening process. • Mesoestetic Hydra-Vital Factor
K for normal and young skins
Other Depigmentation treatments offered by or Mesoestetic Regenerance Active cream
SFMedica include: for oily or mature skins

• The Obagi Nu-Derm System which uses a • For sensitive skins Mesoestetic Anti-stress
unique combination of active and prescription- Face mask is recommended to apply once a
strength ingredients such as Tretinoin and week for skin soothing and decongestion
Hydroquinone 4%. It is proven to be effective
against pigmentation disorders, in particular, • The use of a sunscreen such as Mesoestetic
when combined with the Obagi Blue Peel. Complete Moisturizing Sunblock or
Mesoestetic Dermatological Complete
• The Aesthicare MelaClear is a cost-effective Sunblock is absolutely necessary especially
depigmentation treatment that consists of if treatment is carried out during spring or
the Intense Depigmenting Care Serum, summer.
Depigmenting Maintenance Cream and
MelaClear Sunscreen SPF 50+. For more information on pigmentation disorders
and their treatments please download Dr S.
• Chemical peels are indicated for sun- Foutsizoglou’s relevant article.
damaged skin, pigmentation spots, melasma,
chloasma, post inflammatory pigmentation,
superficial skin blemishes, etc

Aftercare

According to Dr S. Foutsizoglou’s clinical experi-

ence Dermamelan can reduce up to 100% of ab-
normal skin pigmentation, particularly in epidermal
melasma. Patients can usually see a significant
improvement within the first two weeks. How-
ever people need to be warned that it will take
time until results become permanent due to the
rebound effect and complexity of skin blemishes
(see table). In severe cases of melasma, such as
dermal or mixed melasma, maintenance treatment
should be continued for up to 9 months and very

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Dr Sotirios Foutsizoglou
Medical Director | London

Tables

The Fitzpatrick phototype scale

Type Phototype Sensitivity Characteristics
Type I Blond or red hair, freckles, fair Very Sensitive Always burns easily, never tans;
skin, blue eyes very fair skin tone
Type II Blond, fair skin, blue eyes or Very Sensitive Usually burns easily, tans with dif-
green eyes ficulty; fair skin tone
Type III Darker Caucasian, Sensitive Burns moderately, tans gradually;
Mediterranean fair to medium skin tone
Type IV Darker Mediterranean, Asian, Moderately Rarely burns, always tans well;
Hispanic Sensitive olive skin tone
Type V Middle Eastern, Minimally Very rarely burns, tans very
Latin, light-skinned black, Asian Sensitive easily; dark skin tone
Type VI Dark-skinned black Least Sensitive Never burns, deeply pigmented;
very dark skin tone

Classification of melasma according to its depth

Type of Melasma Clinical features
Epidermal • Well-defined border
• Dark brown colour
• Enhanced under Wood illumination
• Responds better to treatment
Dermal • Ill-defined border
• Light brown colour
• Remains unchanged under Wood’s lamp
• Responds poorly to treatment
Mixed • Combination of light and brown patches
• Partial improvement with treatment
• Most common type

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