What is the best way to get rid of melasma?

Melasma is a condition that is managed. This overproduction of pigment is mostcommonly induced by hormones (pregnancy, thyroid conditions)and exacerbated by UV exposure(sunlight, tanning beds),  medication (birth control pills) and even heat.  Understanding these as some of the various triggers for it are the most important tools you'll have in keeping it under control.  A clinical skin care regimen that incorporates a series of chemical peels or a more aggressive TCA peel, such as the OBAGI Blue Peel has produced excellent results in reducing the appearance of pigmentation as a result of melasma.  Home care that is inclusive of a lightener (i.e. hydroquinone)and sun protection(minimum SPF 30) are essential. Incorporating an antioxidant to serve as an additional layer of protection from the sun during the day and a retinol at night to aid in exfoliating dead surface skin cells will also be beneficial. Simply put, there is no cure, but definitely a condition that can be managed. 

Melasma needs a combination approach to get the best improvement and will need a series of treatments. In our practice, we combine Clear + Brilliant, peels, microneedling/PRP, Aerolase, and sometimes Erbium (Cool Laser) to get the best results. Melasma is a lifelong condition that cannot be completely "cured." So, from my perspective, it's less about trying to get rid of it - and more about how we can properly manage it.I suggest seeing a board-certified cosmetic dermatologist for a formal evaluation. Best, Dr. Emer

Melasma is a multi-functional, complicated and often very
frustrating condition.  I always stress
to patients that it will not go away overnight and often times may not totally
go away. However, there are a few key things that will make it better.  Proper skincare is essential and a physical
sunscreen of 30 or higher is a must. I also always stress the importance of reapplying
sunscreen if you are out in the sun every 60 minutes. I also recommend a
compound cream of Hydroquinone, retinol and hydrocortisone. Note that this
should only be used for 8 weeks on, and then a 4 week break in which you can
use a HQ free cream. In my experience, the best way to treat stubborn melasma
has been with medium depth chemical peels. You will usually need between 3-5
peels spaced 1 month apart.

Melasma has multiple causes and therefore has multiple treatments.  It is likely a lifelong condition but can be held under control.  Steps to successfully treat melasma include:-Avoid UV light and exposure and wear daily sunscreen-Investigate hormonal causes -Use of topicals (skin lighteners, retinols, etc)-Use of chemical peels (i.e. melanage, etc)-Use of LASERS (i.e. IPL, erbium, Nd:YAG, ablative treatments)

Melasma is a common disorder that is often
difficult to treat. It isn't unusual for a patient to become frustrated
after trying a variety of treatments in an attempt to obtain
satisfactory results. Like most other complicated skin conditions, a
combination of treatments paired with the proper skin regimen works best!
Topical de-pigmenting agents such as hydroquinone or other melanin
inhibitors along with a topical tretinoic acid to increase skin cell turnover,
hastens the fading of uneven patches. This commitment along with
specific medical-grade chemical peels, appropriate laser treatments and
diligent protection , can enhance the likelihood of reducing or resolving
melasma !

#melasma
#chemicalpeels # unevenskincolor

Melasma is a very stubborn skin
condition caused by both the sun and female hormones. Birth control pills
and sun exposure can exacerbate it significantly. Although there is no
cure for melasma, prescription fading creams as well as in-office peels can
help improve the discoloration.

We have heard from just about every single Melasma patient in our office that they have tried and failed a Hydroquinone treatment program. About 70% of these patients are happy to see after the treatments that they have improved dramatically using a different type of HQ program.
Over the counter and standard prescription strength hydroquinone treatments vary typically between 2% and 4% with 4% being prescription strength. The difference with the Celibre Medical program is that the HQ treatments we use vary between 6% and 14% (for the masks). Using higher doses can lead to much better results and more side effects, which is why we closely monitor our patients on a monthly basis and require that they only go on the program for 3 months consecutively. Because Melasma is a condition not cured but managed, our patients are on HQ for 3 months and off for 3 months. In between they use other products for depigmentation but without the HQ active ingredient.
We are currently performing trials using using the Hoya Conbio Medlite laser with high fluence (energy) high frequency treatments, but have not begun offering this to the general public. The protocols we are using for the trial are based on research from Asia, where Melasma is very prevalent.

Melasma is a common condition caused by overactive pigment producing cells that is often linked to pregnancy but has other causes as well inclduing acne outbreaks, hormonal treatment, sun exposure etc.
The first treatment is to make sure that you are using a complete sunblock with 50 spf or better that blocks UVA and UVB rays. Any treatment will be frought with disaster if continued sun exposure occurs. The second treatment is to eliminate the causative factors like hormone balance, pregnancy, illness, acne control, etc. Again, any treatment while the precipitating cause is not treated will have limited long term improvement.
Once the underlying causes have been corrected or diminished, treatment should include topicals like triluma (combination, retin a, hydroquinone and topical steroid) and possibly other topicals like Kojic acid. Next, intense pulsed light treatments are effective as well as q-switched lasers are also effective treatment. Additionally, TCA chemical peels can be helpful in refractory cases.

Understanding the causes of melasma is the most important step in treating the condition. Melasma is characterized by excessive deposition of pigment in the skin, usually the face.
The causes include:
Hormones: Estrogen and progesterone work on cell receptors on melanocytes to stimulate the production of melanin. Hormones can increase as a result of birth control pills, estrogen replacement, phytoestrogens, and pregnancy.
Sun Exposure
Active inflammation of the skin from skin diseases or acne
Once you control the cause, there are many options including Hydroquinone topical cream, chemical peels, IPL, lasers including Fraxel.
The primary focus of treatment is that there is no cure for melasma, but rather, only treatments. It is a lifelong process that will have to continue as long as the causes continue.

The first thing to understand about Melasma, is that it is a chronic condition that cannot be completely cured.  However, there are still good options for managing Melasma that will lead to a noticeable improvement, which for many people will have important emotional consequences.  
Melasma is a complex condition to understand but it is known there are certain definite triggers, pregnancy being one.  Medicine intended to regulate hormone levels, such as the contraceptive pill, or conditions resulting from a hormone imbalance, can also increase the likelihood of Melasma occurring. 
While some people will prefer to use camouflage make up to even out their skin tone, others may prefer a more interventionist approach.  In my clinic I prefer to use a combined approach of skin peels as well as non-ablative lasers.  
The laser that I use to treat Melasma is SRA, which uses a combination of intense pulsed light (IPL) and bi-polar radio frequency (RF).  All skin types can be treated and improvement will be noticeable within a few weeks.  There is no downtime associated with the treatment, except avoiding the sun immediately afterwards, which will also be necessary on an ongoing basis.  
For anyone considering treatment with a laser, it is always important to check the qualifications and experience of the person who will be doing the treatment.  
Once you have visible signs of Melasma, you will need to stay away from the sun, as exposure will make the appearance of Melasma worse.  Whenever possible avoid sun exposure during the hours of 11am to 3pm when the sun’s rays are at their strongest, wear high strength SPF UVA and UVB products (at least SPF 30 but preferably 50), and wear a wide brimmed hat.  Sunbeds must never be used.