What is the best treatment for Melasma?

As you have discovered, in many instances, Melasma can be resistant to treatment. Often, the more aggressive the treatment, the greater the risk of producing discoloration even more darkening.

The ease with which Melasma improves depends upon the location of the increased pigmentation. When the discoloration (hyperpigmentation) resides in the Epiderms (the outermost layer of the skin), it is usually quite easy to lighten the skin no matter how it is treated (laser, light chemical peels, lightening creams). However, when the discoloration resides in the Dermis (the deeper layer of the skin), it may not be possible to lighten it sufficiently and attempting to do so can cause further darkening. If this is a concern, then a small area of discoloration can be treated with a laser or a chemical 'peel' solution to evaluate it effectiveness and safety. When performing a test past, you should away wait at least 6 weeks after treatment to determine if effective. That's because often during the first 2 to 3 weeks after treatment the Melasma may seem improved but by 6 weeks it can return or become darker than it originally presented.

A lightening cream can be used and, most importantly, it is vital to protect the skin from sunlight - this includes application of sunscreen, wearing a wide brim hat and avoiding unnecessary sun exposure (try walking on the shady side of the street).

Published on Jul 11, 2012

Melasma is an extremely difficult condition to treat and is a very frustrating condition for patients because there is no cure. The available treatments only improve melasma to a certain degree. In our clinic, I find the most success with a combination of Fraxel re:fine and bleaching agents. With this combination, I get about 70-80% improvement. I will do a chemical peel if a patient is uncomfortable in doing a laser treatment. The peel
only has mild improvement in cases when the melasma is superficial.

Published on Jul 11, 2012

Laser treatments can make your Melasma worse in many cases. The tried and true way to treat Melasma is with hydroquinone based bleaching programs. The one we uses has high strength hydroquinone masks and a take home product. These vary in concentration between 6% and 10%, but need to be monitored by a physician because of the high percentages.

Published on Jul 11, 2012