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Melasma is one of the most common skin conditions present. It’s characterized by skin patches of hyperpigmentation. It’s basically a cosmetic problem with no other systemic or skin effects.

The condition is found predominantly in women. In fact, 90% of those suffering from melasma are females. You might hear the names “chloasma” and “mask of pregnancy,” these are all synonymous with melasma and refer to the same thing.

Sites Affected and Symptoms

As we said, melasma is a skin condition causing dark skin patches. It mainly affects areas exposed to the sun so it makes sense that the face is most commonly affected. Predominantly affected areas on the face are the cheeks, chin, forehead, and bridge of the nose. Patches can also present on the neck and forearms but this isn’t common.

Melasma is purely cosmetic. The patches do not itch, hurt, or cause any form of discomfort. There’s also no increased risk of skin cancer. If you suffer from melasma and aren’t bothered by it, you can neglect it. Treatment is only necessary if it’s making you self conscious about how you look.

Causes of Melasma

Sadly, there’s no definite cause for melasma. There are a bunch of risk factors that we know of that can increase a person’s likelihood if getting it, but no direct cause that can be eliminated.

For starters, it seems that people with darker skin tones are more likely to develop chloasma than fair skinned people. Another important risk factor is exposure to sunlight.

Ultraviolet rays from the sun affect the activity of melanocytes in our skin. Melanocytes are cells present in our skin that produce melanin which is the substance that determines how dark our skin is.

Hormonal changes are thought to produce a massive role in the development of melasma. Estrogen in particular is thought to be of particular importance. This helps explain why women suffer from the condition significantly more than men.

Further proof of the importance of the role of hormones is that pregnant women and women on oral contraceptive pills can develop melasma. The fact that the condition is found on the cheeks giving it a mask like appearance and often develops during pregnancy is why some people refer to it as the “mask of pregnancy."


The diagnosis of melasma is straightforward and almost exclusively a clinical one. Any doctor will probably be able to identify melasma upon looking at it, but it’s still best to consult a dermatologist to confirm the diagnosis.

In most cases, no further testing is required and treatment can start straightaway. Sometimes, however, your dermatologist might ask for a few more tests to be absolutely certain of the diagnosis.

Wood’s lamp examination is a kind of test that can be performed at your dermatologist’s office. The benefits of examining a patient’s skin using Wood’s lamp are two-fold. First of all, it’ll rule out the presence of a fungal infection which, if present, would show a certain kind of florescence when exposed to light from Wood’s lamp. The second benefit is identifying how many skin layers are affected by melasma.

This test is seldom required though. Melasma is too common and too easy of a clinical diagnosis to require any form of additional testing. The lack of complications also makes extra tests unnecessary.


Conservative measures

Melasma is fairly harmless. If you’re not bothered by it, you can simply let it be and not seek any form of treatment. Nonetheless, if you’re okay with it now, you probably won’t be if it gets worse or darker. Finding ways to keep existing patches steady and constant is important for everyone.

This can be achieved by protecting your face from the sun. Stay in the shade whenever possible, and if it’s necessary to go out in the sun then apply sunscreen, preferably SPF 30. You might also consider wearing a wide brimmed hat so that its shade protects your entire face from harmful ultraviolet rays.

Some women develop chloasma during pregnancy or while they’re on hormonal contraceptive pills. There’s some good news for them because their melasma will often disappear and be reversed once their pregnancy is over or when they stop taking the contraceptive pills.

For mild cases with very slight pigmentation, makeup can be used to cover the patches. It’ll still be necessary to protect the face from the sun, however, to avoid their progression.

Medical treatment

Hydroquinone is regarded as the first line treatment option for melasma. This drug has a similar structure to that used to treat malaria, but in the form of cream, lotion, gel, or liquid it can be applied topically to lighten hyperpigmented skin patches.

You might find over the counter topical agents containing hydroquinone at the pharmacy. These contain lower concentrations of the drug so are safer and can be used without a prescription.

Other medical options are corticosteroids and tretinoin. These are also great options to help lighten skin. If hydroquinone alone fails to give satisfactory results, your dermatologist might add these drugs to your prescription.

There are available topical creams and lotions that contain all 3 drugs. Taking all 3 drugs is called triple therapy and is sometimes required.


Medicine doesn’t work for everyone; this is where procedures such as laser therapy, chemical peeling, and dermabrasion come in as a last line of treatment for melasma.

Enlighten laser is arguably the best and most effective procedure when it comes to treating chloasma. It works via picoseconds laser pulses to get rid of hyperpigmentation resulting in lighter skin. You may have heard of Enlighten laser as a method of removing tattoos, this is an indication of its power and efficiency.

With Enlighten laser you’ll probably need fewer sessions to remove the hyperpigmented patches. Luckily, Enlighten is associated with less discomfort compared to other lasers and melasma treatment procedures. Any mild discomfort can be avoided by applying a topical anesthetic before starting the session.

The areas treated by the laser might be slightly swollen and red after a session but this effect is short lasting. Your face should return to normal in a few hours, so you can resume your daily activities.

  • Call our Fairfax physicians, Dr. Fatima Aziz, Dr. Syed Ashraf, and Glenda Thomas, NP at Carelife Style Medical Aesthetics in Fairfax, Virginia.
  • We offer complimentary consults to help you choose the appropriate treatment for you.
  • Call us at (703)854-1298
By CareLifeStyle Medical Aesthetics
January 04, 2019
Category: Skin Treatment
Tags: rosacea  

Discover the best approach for managing your rosacea symptoms.

If you are dealing with rosacea then you are no stranger to irritated, red flare-ups on your skin. Of course, we know that the goal of patientsrosacea with rosacea is to be able to tame the redness and flush whenever possible. This is where our Fairfax, VA, team of chief medical officer Dr. Syed Ashraf along with medical aestheticians Dr. Fatima Aziz and Glenda Thomas, DNP can help you manage your rosacea symptoms.

Is it rosacea?

Rosacea usually appears after the age of 30 and it’s characterized by redness or flushing of the face, particularly of the nose, cheeks, forehead and chin. Tiny blood vessels may be visible and sometimes bumps or pimples develop. Those with rosacea will experience flare-ups along with bouts of remission.

Thickening of the skin and chronic redness or flushing are common signs of rosacea. The flush of rosacea often looks similar to a sunburn. Sometimes the skin may appear dry, rough or scaly. Burning or stinging of the skin may also be present.

Is rosacea curable?

Unfortunately, there is currently no cure for rosacea; however, our Fairfax skin doctor can help determine the right treatment option to manage your symptoms and reduce the number of flare-ups you experience. Your doctor may prescribe an oral or topical medication to treat milder cases. Sometimes antibiotics are prescribed to fight inflammation, pimples and bumps.

There are also lifestyle modifications you can make to reduce your rosacea symptoms including:

  • Avoiding your rosacea triggers (e.g. heat; wind; spicy foods; alcohol)
  • Wear broad-spectrum sunscreen everyday
  • Use gentle cleaners and skin care products

Along with medications and lifestyle changes, our medical skin care team in Fairfax also offers the Excel V laser treatment, which is known to target and reduce redness and the visible blood vessels associated with rosacea. This treatment is non-invasive and safe on all skin types.

Whether you suspect that you might have rosacea or you want to talk to our medical aesthetician team here in Fairfax, VA, about the right rosacea treatment for you, call CareLifeStyle Medical Aesthetics today at (703) 854-1298 to schedule an appointment with us.

How Does Laser Tattoo Removal Work?

At our Fairfax office, our doctors use Enlighten, the most advanced laser therapy known to safely and effectively remove tattoos. Most laser tattoo removal systems offer short, nanosecond laser pulses to break apart the ink that lies deep within the skin. Our Enlighten system uses short but powerful picosecond laser pulses, which means that it can remove the tattoo more effectively than traditional laser tattoo removal treatments.

Tattoos are on the rise right now. Some get them just for fun or as part of a dare while others get them for symbolic reasons. While they seem like such a great idea at the time, many people often choose to have their tattoos removed later on.

The Process

When you get a tattoo you’re basically getting ink injected in the dermal layer of your skin. Your skin is composed of two layers: epidermis and dermis. The epidermis is superficial and regenerates while the dermis is the deeper layer.

Once pigment is injected into your dermis certain cells called macrophages arrive at the site of ink injection and “swallow” the ink particles. As your body forms an inflammatory reaction, instead of clearing the ink particles and the macrophages it’ll instead trap them where they are.

This is why tattoos are permanent and don’t fade with time. The ink is inside macrophages and both are embedded into your skin. Perhaps as a person gets older the tattoo starts to lose some if its quality and details because the ink penetrates deeper into the skin.

Hazards of Tattoos

The pain is what most people worry about and getting tattoos is relatively harmless otherwise. How much pain a person feels will depend on their pain threshold as well as the tattoo artist’s skill.

Another complication one should be aware of is the possibility of developing an allergic reaction. This can happen during a person’s tattoo or on subsequent ones if the body starts developing an allergy to the ink used.

Allergic reactions could be mild with some skin redness and itching or they may be so severe that they result in an anaphylactic reaction. Anaphylaxis is potentially lethal since it stops a person from breathing and could end in death if not treated immediately.

Infection is a very mild risk nowadays since tattoo parlors sterilize and renew their equipment regularly to avoid being the reason someone got infected with a disease. Pathogens that can be transmitted by getting a tattoo include hepatitis B and C, herpes, HIV, and even tetanus.

There’s no reason to worry though because tattoo artists are very careful when it comes to sterilization and disinfection. These issues still exist due to unclean tattoo practices such as getting a tattoo in prison.

Taking Care of Your Tattoo

The tattoo artist will cover it with petroleum jelly and a bandage once he or she is done. That bandage should be removed after 24 hours and the tattoo washed with water and antimicrobial soap then dried lightly.

For the next 3-4 weeks you should wash the tattoo a couple of times per day while applying antibacterial ointment twice a day without adding a bandage. It would also be a good idea to not go swimming or expose your tattoo to the sun for a couple of weeks. Also try not to shower with very hot water as that can wash off some of the ink.

You might experience some pain or pricking over the tattoo but you shouldn’t scratch it or try to peel it. This should go away for a few days. Picking at it will remove the ink and might result in an infection. You definitely don’t want either.

Tattoo Removal

25% of people with tattoos say they regret their decision and would like to get their tattoo(s) removed. This can easily be done at a trained professional’s office using laser therapy. Laser works by emitting high intensity light beams which destroy the pigment colors.

Black tattoos are the easiest to remove because they simply absorb wall wavelengths so the effect of laser is maximized. If your tattoo has other colors then your doctor will determine the right lasers for those colors in order to ensure a complete and successful removal.

Naturally the smaller a tattoo the fewer laser sessions it’ll take to remove it while larger ones will need more sessions. Nonetheless you should notice the color of your tattoo fade a little more after each session indicating that the treatment is working.

Laser therapy is often a little uncomfortable and local anesthesia might be used by your doctor. Applying ice to the area after a laser session will definitely help reduce the pain and discomfort too.

Side Effects of Removal

You got a tattoo then decided to get it removed, that’s a lot of trauma to the skin considering the introduction of ink followed by an inflammatory reaction then the trauma from laser.

First of all there’s the risk of an infection. We’re not talking about serious disease transmission such as hepatitis or HIV, what we mean here is local skin infection and inflammation. It’s not pleasant and might affect your treatment but it’s not really dangerous.

There are also a few skin complications that might happen affecting the pigmentation of that skin area. First, your tattoo might not be completely removed especially if it has several colors. If it contains darker colors like black and blue then it has a greater chance of being successfully removed completely since these absorb almost all laser wavelengths.

The other issue with pigmentation is that skin exposed to the laser might suffer from hypo or hyperpigmentation. This means that in place of the tattoo you could end up with slightly lighter or darker skin.

All of these side effects can be avoided by using advanced laser techniques and visiting an expert.

Enlighten Laser

Enlighten laser tattoo removal is one of the best laser options out there. This is because the device uses picoseconds laser pulses to destroy the ink in your dermis. These pulses are shorter but more powerful than most other lasers available. You have a better chance of getting your tattoo completely removed and in fewer sessions using Enlighten Laser.

This method may also result in some patient discomfort but according to those who have experienced Enlighten and other laser therapies: Enlighten is associated with less discomfort. Anyhow it can be avoided by applying a topical anesthetic.

You might also notice that the area exposed to the laser is a little swollen and red but this is temporary. Generally, you will be able to resume your normal activities in no time.

Why Go with Enlighten?

Simply put, Enlighten is less painful, more effective, and faster. Whereas Laser Tattoo Removal can take many treatment sessions, Enlighten can get rid of a tattoo within two treatment sessions–and you’ll heal from it faster when everything is said and done.

Want to know more about the best laser tattoo removal service in Fairfax, VA and learn more about how Enlighten works? Contact us today to schedule an appointment (703)854-1298

Acne needs no introduction. It’s no surprise that it’s the most common skin condition since almost all of us have suffered (or unfortunately continue to suffer) from it.

What causes acne?

Acne is a chronic inflammatory condition related to our sebaceous glands that results in the famous pimples which mostly occur on our face.

Normally we have sebaceous glands that secrete sebum to keep our skin and hair from getting too dry and to eliminate dead skin cells. These glands secrete sebum through follicles in our skin. So far this is all normal and there’s no acne.

What happens is that these follicles can become blocked leading to accumulation and trapping of sebum. As the sebum accumulates it results in a swelling which is the pimple that you see. This swelling can increase and inflammation can occur when bacteria called Propionibacterium acnes become involved.

Acne is relatively harmless since most of us have experienced it at least during our adolescence, but sometimes in cause scars which can result in great distress.

Where can you get acne?

The condition most commonly presents on the face which is what most of us go through, but it’s definitely not exclusive to it. Other common sites of acne are the chest and back because they have rich oily secretions as well.

In general you can get acne or “sebaceous cysts” anywhere in your body except for the palm and the soles. These areas can never develop acne because as we said the condition is directly related to the presence of sebaceous glands. Luckily these glands are completely absent in our palms and soles.


You may have noticed that you had the worst acne of your life during middle and high school when you were between the ages of 12 and 18. That’s because there’s a lot of fluctuation in your hormone levels during puberty and adolescence.

Hormones, particularly androgens, trigger acne by stimulating your oil/sebaceous glands to grow which increases the likelihood of one of them getting blocked and forming a pimple. You can expect your acne problem to ameliorate with age as your hormone levels stabilize as you get older.

Other factors

Some people are more genetically predisposed to acne. You might notice that you and other family members suffer more from the condition than other people your age. Or you might notice that two siblings at your school have a particularly bad case of acne.

Other things that can contribute to flaring up of acne include drugs that contain androgens, hormonal changes, and simply stress. During stress your body might increase its productions of androgens and in severe stress some females might even have a drop in the production of estrogen. All of these tip the balance towards androgens taking the upper hand.

Acne scars

In some cases acne can be complicated by scars. This occurs when there’s infiltration of the deep layers of the skin responsible for regeneration resulting in a disfiguring scar that can be the cause of great distress for a person.

Scars can be categorized into two main categories: atrophic or hypertrophic.

Atrophic scars are depressed ones because as the name suggests the skin has “atrophied.” Atrophied skin means it has repaired less than necessary and there’s no enough collagen to repair the wound left by the pimple. Atrophic scars can be boxcar, ice pick, or rolling.

Boxcar scars are U-shaped scars that can vary in depth. The shallower they are the more likely they are to respond to treatment. Ice pick scars the most difficult to treat because they may seem narrow but in reality they penetrate deep into the skin. Finally we have rolling scars with rounded edges and a rolled appearance.

Hypertrophic scars are ones where too much collagen is made to the extent that it’s become disfiguring. These are simply scars that are raised above the surface.

Treatment of acne

Mild acne that most people suffer from can be treated by over the counter skin creams and gels. The most popular of these are benzoyl peroxide, resorcinol, salicylic acid, retin-A, and azelaic acid. These drugs have multiple mechanisms of action.

  • Benzoyl peroxide works by killing the Propionibacterium acne we talked about earlier helping limit inflammation and speed up skin healing and replacement
  • Resorcinol helps break down blackheads and whiteheads
  • Salicylic acid is basically aspirin but in a topical form which controls inflammation
  • Retin-A derived from vitamin A boosts skin healing
  • Azelaic acid controls bacterial growth and stops sebum eruptions

More severe forms of acne may require oral antibiotics to control infection. Additionally your doctor may prescribe oral contraceptives in order to correct the hormonal imbalance which is flaring on your acne.

Another form of treating severe acne is by injecting it with corticosteroids. This will significantly hold back inflammation and speed up healing. It’s mainly used for large acne cysts that would probably result in scarring once they rupture.

Isotretinoin is often reserved for resistant cases as it is very effective but has plenty of side effects. It is also derived from vitamin A. It is taken orally so is drastically different from Retin-A. Women who are or even might be pregnant should never take this drug.

In general never use any of these drugs without consulting your doctor first.

Treatment of acne and acne scars at Carelife Style Fairfax Office

There are a couple of ways to treat acne and acne scars and all of them will require a visit to your doctor. Our personal favorite is using laser genesis relying on excel-v platform.

Laser genesis can easily clear your acne scars using a moderate amount of laser waves and absolutely no pain. The session takes between 20-30 minutes and you will not require anesthesia or any other form of preparation except for your eyes to be covered using goggles.

Treating acne using laser genesis is absolutely pain free, not time consuming, and you will only need between 3-6 sessions in order to clear your acne. During the procedure your doctor at Carelife Style will ensure you get the most appropriate treatment based on your skin type without causing any damage to the overall health of your skin.

Another up and coming laser treatment for acne scars is Pearl Fractional Laser with XEO laser platform. Pearl Fractional laser will stimulate your body’s healing process at the sites of the damaged areas while leaving healthy skin unaffected.

You’ll usually only need one session and healing should be complete within a month. It’s recommended to use a topical anesthetic with Pearl Fractional Laser as opposed to Laser Genesis. You might also experience swelling and mild irritation at the sites of treatment for up to a week.

Pear Fractional is not just used to combat acne scars, but can also be used to improve your overall skin conditions helping you overcome imperfections due to aging and sun damage. The technology truly offers the ultimate combination of safety, patient satisfaction, and a speedy recovery. You’ll definitely notice the difference in your complexion after just one session of treatment.

Other methods of treating acne are:

  • Dermabrasion and microdermabrasion which rely on a high-speed brush and a spray of small crystals, respectively, in order to clear scars.
  • Chemical peels can be used to remove the superficial layer of skin over a scar giving it a more even appearance.
  • Punch excisions are more radical as they involve cutting out the scars and repairing the skin defect by stitching it or applying a skin graft.
  • Skin grafting can be used alone or in combination with other forms of treatment. It involves covering a defect with a piece of skin from another area of your body most often from behind your ear.
  • call our Fairfax physicians, Dr. Fatima Aziz, Dr. Syed Ashraf, and Glenda Thomas, NP at Carelife Style Medical Aesthetics in Fairfax, Virginia.
  • We offer complimentary consults to help you choose the appropriate treatment for you.
  • Call us at (703)854-1298

Obesity is an epidemic in the United States with over 35% of adults and over 15% of children and teens suffering from it according to the CDC. The term isn’t something you can just throw around at people who seem to carry excessive weight. Obesity is classified into several grades according to a person’s body mass index (BMI).

You can calculate your BMI without any medical assistance at home if you know your weight and height. Simply divide your weight (kgs) by your height squared. Here’s the equation for you: kg/m2.

If you weigh 80kgs and your height is 175cm your BMI equation will look like this: 801.752 which equals approximately 26. So what does a BMI of 26 mean? Here are the different BMI ranges and what they translate to:

  • BMI 19-24.99 is normal
  • BMI 25-29.99 is overweight or pre-obese
  • BMI 30-34.99 is obese class I
  • BMI 35-39.99 is obese class II
  • BMI over 40 is obese class III

So basically you’re only considered obese if your BMI is over 30.

Causes of Obesity and Weight Gain

Your diet and how much/often you exercise are the two main determinants of your weight. You’re not doing your body any favors by eating fast food and having lots of fat, calories, and junk food in your meals. This is made even worse by a lack of exercise.

It’s not necessary to cut out all the food you love from your diet, just eat it in small amounts and make sure you burn off those extra calories by exercising. Eating poorly and having a sedentary lifestyle will surely result in weight gain.

Other factors include genetics and a lack of sleep. By not sleeping enough your brain produces hunger hormones that drive you to eat thereby increasing your appetite.

Pregnant women naturally gain between 9-14kgs most of which is lost after delivery. Some women, however, have difficulty losing that weight especially if they gained weight in excess of the normal 9-14kgs.

Your weight gain could be pathological due to an underlying disease such as Cushing’s disease or hypothyroidism. If you suffer from these conditions you’ll often have lots more to complain about physically than just weight gain and you should visit a doctor.

What is Stubborn Fat?

This is a kind of fat in our bodies that is so adequately named because it simply refuses to go away. When we decide to lose weight we might do everything that’s asked of us. We eat right, exercise several times a week, and get enough sleep. Somehow there’s fat in certain areas of our body that refuses to go away.

You’ll often find stubborn fat around your hips, butt, thighs, and as love handles. These are all storage sites for subcutaneous fat. Visceral fat which accumulates around organs such as the liver is much easier to burn and eliminate. So why is it that there are places in our bodies where burning fat is much easier than the rest?

Let’s first take a look at what our body does during periods of stress where it needs more energy and fuel. As you start exercising your blood glucose levels start to drop since they’re being consumed by your muscles. Your body will then release adrenaline and noradrenaline which as we all know are part of our stress hormones.

These hormones can act on two different receptors: alpha receptors and beta receptors. When they bind beta receptors on stored fat inside your body your body will begin to break down that fat and release it into the blood so your body can take advantage of it as fuel.

Stubborn fat is different because it has more alpha receptors than beta. Alpha receptors are less receptive to these changes and are less likely to result in breaking down of fat and its release into the blood.

There are factors that increase your likelihood if developing stubborn fat and all have to do with alteration in your metabolism. These include aging, sleep deprivation, too much stress, and low levels of thyroid hormones.

Other Complications of Obesity

Obesity isn’t just about how you look. Your entire body and all your organs can suffer greatly from obesity.

Excess weight is one of the major causes of ischemic heart disease, diabetes mellitus, and hypertension. Diabetes and hypertension will definitely aggravate the ischemic heart disease and also increase a person’s risk of having a stroke.

Cancers can also be caused by obesity. Obesity is an important risk factor, particularly in breast, endometrial, and colon cancers.

Gallstones, liver disease, high cholesterol are all predisposed to by excess weight as well. Some people develop sleep apnea because their airways become obstructed as they sleep. There’s also the added risk of arthritis as a person’s knee joints become incapable of handling all the extra weight.

Weight Loss

Treating weight loss isn’t complicated unless you’re suffering from high grades of obesity and comorbidities. As we all know the most important ways to lose weight have to do with what we eat and how often we exercise.

Cut back on fast food and fatty food. Work out 3 or more times a week for over 30 minutes per workout. These techniques will help you get rid of the excess weight and also alleviate your mood through the release of exercise endorphins.

Alternatively, if these don’t work your doctor might prescribe weight loss medications or even advocate weight loss surgery such as gastric banding or gastric bypass. You’ll need to discuss these options with your doctor in order to fully understand their benefits and hazards.

Getting Rid of Stubborn Fat

Your best bet for getting rid of stubborn fat over your hips and waist is to ask your doctor for Trusculpt 3D. The device uses radiofrequency technology in order to heat and dissolve subcutaneous fat and eliminate it permanently.

This is completely non-invasive and is done from the outside using a probe. Once the fat dissolves your body will then eliminate it. Your skin will feel warm during the sessions, but won’t get too hot that it becomes uncomfortable.

A session lasts about 15 minutes per treatment area and will result in nearly 25% fat reduction. You’ll see some results immediately with the full effect taking place within 12 weeks. There’s also no downtime since you’ll be able to resume your daily activities normally although some skin tenderness may persist for a day or two.

Trusculpt 3D is pain-free, requires no anesthesia, has no downtime, and shows fast and reliable results when it comes to getting rid of stubborn fat.

To learn more about truSculpt 3D, please call our office today to schedule a consultation at (703)854-1298.

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