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 16

Melasma is a very difficult condition to treat.

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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
4.9 out of 5 stars 430 reviews

Best Chemical Peel for Melasma

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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
4.7 out of 5 stars 46 reviews

Best Peels for Melasma

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We have two proprietary peels that our office has found to be very successful in treating pigmentation of melisma:  The Perfect Peel and the VI Peel.  These were specifically created to treat pigmentation issues and we have found them safe with darker skin tones and with melasma.   Jessner's peels are inexpensive and are great to use on larger skin areas such as the back for pigment issues.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

There are many different types of peels for more

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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. 


Dr Davin Lim 
Laser and Aesthetic Dermatologist

Melasma Peel and Cosmelan

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Cosmelan is the best peel for Melasma.  I have been using this and chemical (TCA) peels with Retin-A and Hydroquinones with fabulous results.  I would stay away from lasers since it can sometimes make Melasma worse and make re-treatment more difficult.  Strict sun block is essential at preventing recurrence of melasma.  Please consult an expert in melasma for the best cosmetic results.  Best, Dr. Green

Perfect Derma Peel get results for Melasma patients

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There are many chemical peels on the market today.  Medical-grade peels are going to be the best when it comes to treating Melasma.  Topical home care is very important too. If you can’t use hydroquinone, other options are Kojic acid, Vitamin C, Licorice Extract, Arbuti, or a blend of them).  And of course most importantly is being religious about sun protection i.e. hat, sunglasses, etc.. and a good sunblock repeatedly applied every hour!

In our experience, we have found the Perfect Derma Peel for Melasma works very well. The active ingredients are: TCA, Retinoic Acid, Salicylic Acid, Kojic Acids, Phenol, Glutathione and Vitamin C.  So with the cell turnover you also have antioxidants that inhibit melanin production and brighten the skin.

Hope you found this answer helpful.  All the best!

What Really Works Best for Melasma

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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 and the Chemical Peel

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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 Dermatologic Surgeon

It really depends at what level the melasma is located

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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

Melasma Treatments

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Melasma can be difficult to treat.  There are a variety of peels which target pigmentation but in our office there are a variety of peels used to target hyperpigmentation including Melanage, PCA Peel with hydroquinone, and others.  Many peels come with post treatment kits and may recommend a series of peels.  For some patients, if peels are insufficient, laser therapy can be used.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 171 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.