Melasma Peel: What Works Best?

I provide IPL PhotoFacial treatments for brown discoloration of the skin. I have stopped trying to treat melasma, since my StarLux IPL treatments have not been satisfactory, and sometimes problematic. You should consult a certified dermatologist that has favorable photos of melasma treatments. I don't think there is one specific "best treatment". I have read about erbium laser treatments as working well, but I think the experience and preference of your physician is of utmost... more

I think chemical peels work beautifully for melasma.  I have a large number of patients with darker skin tones and melasma is a significant problem especially in sunny Texas.  I like both SAHA and light TCA peels for melasma.  A nice side effect is that wrinkles, scars and sun damages are also improved!

Melasma usually takes 3-5 light chemical peels such as Jessner's solution ($175 each), a good prescription bleaching cream($75-100) nightly and a daily sunscreen. I used to be more aggressive in treating melasma with higher strenght chem peels or IPL treatments or laser treatments but the results were so unpredictable and could make it worse so i do more gentle treatments and have great success. Peels should be done yearly and bleaching creams at least once a week forever to prevent the... more

I would suggest that the MOST important treatment for melasma is for the patient to use a proper sunscreen 365 days a year. I have seen patients improve, then stop avoiding the sun and have the melasma return very quickly. Keep in mind, we doctors dont CURE melasma, but we treat it. You have to keep on avoiding the sun which, with your hereditary disposition to getting it, is the source of the problem. Any peel that doesn't cause too much redness (like the Jessner's formula) or you are at... more

 Melasma may be better treated with skin care products such as Obagi, rather than having a chemical peels or laser procedure.  IPL sometimes helps as well.

Melasma can occur in many different layers of the skin. Most of the time the melasma is located in the epidermis which is the layer above the bottom layer of skin cells where the stem cells reside. There are times when the pigmentation gets deposited into the dermal layers, or the layers beneath the stem cells. Peels differ in the level that they penetrate. 10-20% tricholoroacetic acid peels (TCA) usually stay in the epidermis but if applied more times can go beneath the stem cell layer.... more

I would recommend that you consider things other than peels, though I recommend the ViPeel or Obagi for melasma. First consider hydroquinones like Triluma. You may need to combine microdermabrasion for best results. It is most important to include sun blocks and protective garments to protect your investment in you! sek