What To Do When Melasma is Difficult to Treat?

Hi Dr. Irwin I'm a 45 years old spanic suffering with melasma for the last 4 years I tried different products in the past including triluma nothing helped. At the end of August of this year I ordered a product on line called BLEMISH FREE comes on spray can. I sprayed this on all the brown spots on my face and 2 weeks later I was left with eve darker spots (dark brown) this product burn my face so bad I did some research about it and found out was liquid nitrogen, immediately I went to see a dermatology who performed 2 photorejuvenation treatments 2 weeks apart. Is exactly 4 weeks from my last laser tratment and don't look any better. Should I leave it alone and let time heal my skin or is this a permanent damage?

I really, really, really recommend that you try to find a good dermatologist experienced with hispanic skin in your area.  You didn’t tell what area you live in.   It makes me sad to think that these over the counter products are being sold with no warnings about the damage they can do, especially on the face.  I would never, never recommend liquid nitrogen on the face for melasma, especially in August.

 If you haven’t read our section on melasma for all the basics about sunscreening (must block UVA!) and getting off contraceptives (with doctor’s approval) that could be aggravating the melasma, please go read it first.  I think you would benefit from a prescription bleaching cream (your dermatologist has lots of options and can help you find one that works for you) coupled with a series of light peels.  The peels are usually done about 4-6 weeks apart in a series of 3-6.  Dr. I

Dr. Brandith Irwin, MD

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