I have small brown patches on both my upper cheeks and I am not sure if they are melasma or sun damage. I read that treatments for sun damage (IPL, laser treatment) will not help with melasma. My question is, is the reverse also true? If I use a topical cream and my spots are actually sun damage, will I see any results?
Treatments for Melasma Vs Sun Damage
Doctor Answers 4
Lightening creams help both melasma and sun damage
Products such as Triluma, Blanche, Lumixyl etc will improve pigmentation from both melasma and sun damge. The new Fraxel Dual is also good for both of these problems.
Melarase creams for pigmentation and skin discoloration and dark spots on the skin
Melasma and skin spots are caused by several factors which you have assessed accurately. I would begin treatment with topical creams such as Melarase and then continue with once monthly MelaPeel treatments to exfoliate and drive out some of the pigment.
Go Both Ways
These often are one and the same. Without question, the leading cause of extrinsic aging of the skin is sun exposure. One of the results of sun exposure is what we dermatologists call dyschromia. This is a fancy name for the unattractive pigmentation which blotches the skin.
Besides the prudent use of sunscreens, there are two main types of topicals which can be used. One of these would be a Retinoid. Retinoids, besides being an anti-aging formulation can also handle dyschromia on their own. However, adding something with hydroquinone, or a hydroquinone relative like arbutin will give your regimen even more potency. There are a host of other fine ingredients which will decrease pigmentation: licorice, niacinamide, glucosamine, paper mulberry, kojic acid, and azelaic acid.
Triluma, a prescription product combines a Retinoid with hydroquinone (and a mild steroid).
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Different treatments for Sun Damage vs. Melasma
We think hydroquinone bleaching programs are an excellent option for Melasma. We have not found TriLuma or any other 4% prescription to really do the trick for resistant Melasma. With more difficult cases, we use two programs, one that is produced for us by a pharmaceutical company and another called Cosmelan. The % of hydroquinone bleaching agent in these products is much higher than the standard prescription and thus yields better results.
For sun damage, the gold standard is q-switched lasers. Q-switched lasers are the same type used for tattoo removal, birthmarks, freckles and other pigmented lasers. They are hands down the most effective for any type of pigmented (brown) sun damage. Good luck