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Melasma Peel: What Works Best?

Which chemical peel would you recommend for melasma? Will melange peel help? How long do chemical peel results last for this problem?

Doctor Answers (9)

Melasma is a very difficult condition to treat.

+2

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 importance.

I hope this is helpful, and best regards.


West Orange Facial Plastic Surgeon
5.0 out of 5 stars 287 reviews

There are many different types of peels for melasma.....read more

+1
Melasma is a very difficult condition to cure, but it can be improved. Most dermatologists have move away from mid to high strength peels (eg Jessners+ TCA), and now agree that multiple low strength peels are better. Peels only form one arm of melasma treatment, the other treatments such as bleaching creams, sunprotection and vitamin A creams are equally, if not more important than peels alone. 

Now, to answer your question-

1. Glycolic acid peels 20% working to 70%, Multiple peels (My favoured peel)
2. Lactic acid peels
3. TCA 8% - multiple peels, no frosting. 
4. Vitamin A peels Tretinoin 1-2%, wash off in 3-6 hours depending on skin sensitivity 

Hope this helps. 

Regards, 

Dr Davin Lim 
Laser and Aesthetic Dermatologist
Brisbane, AUSTRALIA

Davin Lim, MBBS, FACD
Brisbane Dermatologist
5.0 out of 5 stars 2 reviews

Best Chemical Peel for Melasma

+1

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 darkening from returning.

David Hansen, MD
Beverly Hills Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

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Melasma and the Chemical Peel

+1

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 risk of trading MELASMA for Post Inflammatory Hyperpigmentation!

Beverly Johnson, MD
Silver Spring Dermatologist
5.0 out of 5 stars 3 reviews

Melasma treatment

+1

 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.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

It really depends at what level the melasma is located

+1

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. 20-35% TCA peels tend to go a little deeper and can go below the stem cell layer and get some of the deeper pigmentation.

One thing to remember is that the deeper you go the more time it takes to heal and the more risk. 10-20% TCA peels take 3-5 days to peel and heal. Where as 20-35% will take from 4-7 days or more to heal and peel. A woodslamp can help determine the depth of the pigmentation: contrast in epidermal pigmentation is increased while contrast in dermal pigmentation is decreased under Wood's lamp illumination compared to ambient visible light.

Philip Young, MD
Bellevue Facial Plastic Surgeon
4.0 out of 5 stars 38 reviews

MelaPeel and Melarase for melasma and skin pigmentation

+1

I use a MelaPeel for melasma and skin pigmentation.  I recommend at least two weeks of Melarase AM and Melarase PM before the peel.Surgery90210

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 53 reviews

Chemical peels are one of my favorites for melasma

+1

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!

Victoria W. Serralta, MD
Arlington Dermatologic Surgeon
5.0 out of 5 stars 1 review

Perhaps, not a chemical peel at all?

+1

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

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 51 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.