Dark Melasma and pigment problems: what to do when you feel hopeless (men & women)

I have melasma and very depressed ! Hi. I'm 26 asian man and I have very dark melasma. It appear suddenly and I went to several dermatologist and they said it is not melasma but it is capillaries. Whatever it is, it look very dark in the mirror. I have tried laser, injection, facial, bleaching cream and they still look the same after several months. I haven't go out for 3 months or if I do I have to wear a facial mask to cover my entire face. This is not funny and I think I can't live it. If you have any treatment that could make it better please let me know. I would not hesitate to travel and meet you. Thank you very much.

Firstly, my heart goes out to you. Dealing with dark Melasma and pigment problems, especially on the face, can be very hard. Men, like many women, have times in their lives when they feel very unhappy or disfigured in some way. You are NOT alone. But it doesn’t feel like it sometimes. Please reach out to your primary care doctor or a counselor today to help you through this. There is no shame in needing help. We all need it at times.

On your question about very dark Melasma, here are some thoughts.  You’ve already been incredibly resourceful, and seen two different dermatologists without a solution.  I’m not sure where you live, but you may need a dermatologist in a larger clinic, someone more used to complex cases. The Mayo Clinic or the Cleveland Clinic would be an example of such a regional resource. Or, try a large University dermatology clinic.

Finding help for dark Melasma, and other problems on the face that are not easy to solve

  • Please see my comment above on how to find better dermatologists who can help you.
  • Try Googling to find a doctor who specializes in this condition at a major medical center.  Just beware all the false advertising, click-bait, etc. that will go with this search.  You’re looking for a legitimate MD, national expert.  For example, search “university melasma Phoenix “(or where ever your are).  Ignore all the Google ads too. Google is becoming increasingly useless due to all sorts of people being able to buy and manipulate search terms, in my opinion.
  • Try the AAD.org which is the National Academy of Dermatology. all the board certified dermatologists in the country belong to this, including me. A search for a “Melasma expert” there may turn up a doctor near you.
  • Question the diagnosis. Often if a treatment isn’t working, IT ISN’T THE TREATMENT THAT’S THE PROBLEM, it’s that the diagnosis is wrong! If the diagnosis is wrong, then the treatment won’t work.
  • Write down or request the written notes from the dermatologists you’ve seen.  You have a legal right to these, in the U.S. and in most parts of Europe. The notes will show what the doctor thought the diagnosis was, and the suggested treatment plan. TAKE THOSE MEDICAL NOTES TO ALL FURTHER APPOINTMENTS! This helps the new doctor see what has been done and what the thinking was.

I really hope this helps and know that everyone who reads this is supporting you!  – 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 skincare advocate.

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