Melasma – problems and risks with peels and melasma and many other melasma questions!

I started developing melasma about a year and a half ago (I am 30 years old), and in the beginning had no idea what it was. It showed up after a series of changes in my birth control pills - From Yaz for several years to Loestrin, than to April (the Loestrin caused me misery with constant acne, but I didn't realize the cause until I had been miserable for about a year). I still have breakouts and use Ziana (mild retina) gel nightly. I had several glycolic melanage peels and in the beginning the melasma started to fade. Then my aesthetician tried a jessner's peel which really peeled unevenly, and since then my skin has been horribly discolored and patchy. I stopped all birth control about 7 months ago and have tried 2 other melange peels since and neither seemed to make much difference. I am very depressed. Could the jessner's peel have caused permanent damage? I have noticed more melasma spots recently and this is discouraging because I thought after the BCP left my system it would eventually fade? Shouldn't I see a difference 7 months after stopping, or could the melasma be permanent? I wear sunscreen (46% elta md) daily. My dermatologist told me I needed to wait it out and see. Harsh products seem to only irritate me so I am stopping all bleaching creams. I really appreciate any help, I am so unhappy with my skin.

I’m sad that you had this experience. Everyone with melasma and/or acne gets very frustrated at times and your experience with all of this has been distressing, to say the least. I hear that you are feeling depressed so please – can you get some help with the depression – while your skin is slowly improving? See your primary care doctor first and tell her/him the problem.


I particularly wanted to answer your questions because all of a sudden I’m seeing articles in the women’s magazines extolling the virtues of peels – and the information is not especially accurate and some of it is misleading about the risks of peels. Your question illustrates it well.


Usually a peel like a Jessner’s isn’t deep enough to cause permanent damage but it can cause a serious case of what we call post inflammatory hyperpigmentation that can take sometimes, 6-12 months to resolve with good care.


Can you please read for me carefully all the content in these 3 links below. Most of your questions are answered there. Then write me back with any remaining questions, and I’ll try to answer them for you and everyone out there who’s struggling with melasma or PIH.



Ignore the parts on peels and hydroquinones for now, since they are clearly making things worse.


Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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