What can I do about melasma?
I still think that melasma is the toughest problem to treat because there is no cure for it – just good control. You will absolutely need the help of a dermatologist who’s interested in this problem. You should see him/her at least twice a year.
First, You MUST NOT be on any type or oral birth control or estrogen creams, patches or tablets if you want to make progress. See your OB/GYN for other options if you are. Second, you MUST double sunscreen every day with both sunscreens containing UVA blockers as well as UVB. For example, use a mexoryl based sunscreen as a base with a powder sunscreen with a high percentage zinc (like ColoreScience), titanium or other minerals – or a mineral makeup (like Jane Iredale) over that. These are the basics.
Then, what has been proven to help most is a combination of intermittent (not continuous) use of products containing hydroquinone (like Triluma), light to medium peels, and retinoids like Renova. You need help from a dermalogist because sometimes these products can make you worse IF you become irritated by the product – even very subtle irritation. No laser that I know of is proven to make melasma permanently better at this time. And, because they are expensive, I don’t usually recommend them because improvement is temporary.
Have your aesthetician look at the Illuminize and Vitalize peels systems. In knowledgeable hands, these are usually quite safe for melasma patients. Dr. I