The melasma upper lip “moustache.”

Dr. Irwin
April 12, 2015
I had my son 2 years ago and immediately went tanning after ... I got melasma on my upper lip not knowing what it was I continued to tan... I quit after research then let it fade on its own.. it was faded pretty well but it wasn't enough for me so I went to derm and he prescribed me hydroquinone 4 percent and retin-a for breakouts and to mix with my hydroquinone at night... I noticed the pigment looking red and also darker at same time so I knew it was irritated I quit the creams it's been a week but I don't notice any change but very slightly. Is there anything I can put on it to take redness away? I'm so embarrassed the worst part is I'm a hair dresser and see multiple people each up close. Makeup doesn't help at all it makes it more noticeable or it doesn't look right cuz it's on my upper lip so it's hard to layer there

That dark line above the upper lip is fairly common for melasma and soooooooo annoying!  If you read the section on hydroquinones, you’ll know that it’s not uncommon for about 10% of people to be irritated by hydroquinones, which makes the melasma worse, at least temporarily.   One of the reasons that the prescription (in the US) “triple” cream Triluma is often the best tolerated is that it has the hydroquinone, the tretinoin (Retin A), and a mild steriod to reduce irritation ……all in the same cream and in the right balance.    In  my and many other dermatologists’ opinion, it causes less irritation for those reasons.

Generally, here are some things to try:

  • Stop the irritating product (like you did);
  • To calm the irritation down, use non prescription hydrocortisone cream 1% twice a day for 4 days, once a day for 4 days and then every other for 4 days.  In other words, a taper!   Don’t stay on it longer than that and, if you get worse at any point, call your doctor;
  • Double sunscreen this area –  Use a good zinc based sunscreen like this Elta sunscreen and layer this product over it (ignore that says eye cream on the label)
  • Good cover up  that doesn’t look cakey!

Hope this helps,  Dr. I

Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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