What can I do about melasma?

Dr. Irwin, I was diagnosed by a dermatologist a few years ago with melasma. I have also had slight acne and with my pregnancy 2 years ago my melasma was really dark. I am 35 years old and the melasma and acne started in my late late 20\'s. I have had numerous laser treatments (ip-Fraxel) and they helped some and broke up some spots but I still have really dark spots all over my face. It is uneven all over and very oily. I'm searching for a good glycolic peel but have not decided on anything. Do you have any recommendations on what to try now or what type of peel to use. I used the Obagi for months and still use some of the products but the hydroquinone didn't seem to make a difference. Help DWebb

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

 

 

Dr. Brandith Irwin, MD

Ask me your skincare question!

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

  • All our content is written and researched by myself.
  • My medical office in Seattle has treated thousands of patients for 15+ years.
  • This site is not affiliated or financially tied to any product, treatment or device.
Ask Me Something
SkinTour Skincare
One of the best investments in your skin is your daily skincare. Why? Because you can prevent many problems with blotchy skin color, lack of glow, texture, some types of acne, and fine lines with good skincare products. You can also correct some of these problems with effective skincare products. Great skincare is often more expensive because quality ingredients are expensive. Some companies spend on research/development which benefits all of us and adds to the cost. Are they worth it? In general - yes! I have handpicked some of what I consider to be the best skin care products, and offer them for sale on SkinTour's shop. This is based on my team and I's testing and research at our clinic. Many of the products are in my own regimen. What could be better than using skin care products a dermatologist uses?!