Does melasma get worse after stopping the kligman cream? (Photo)

I would recommend the Melarase Brightening Kit to control your melasma. Once the skin is more even toned, switch to a twice weekly regimen. Best, .Dr. Karamanoukian#Realself100 Surgeon

BCP is known to worsen melasma.Melasma needs long term commitment with skin care and avoidance of skin factors such as sun exposure (Spectrase Sun Block) which has wide UV spectrum and SPF 30+ protection. 
Daily good habits with topicals may well help you chieve your goals with a good skin system like the Brightening Kit from KareSkin (see link). You may want to start with Melarase and Pigmentation Correction Complex. Scler-X from another vendor is for PIH relief (see link). 
Melarase AM is non hydroquinone based. 
Clear + Brilliant laser can be added once you start your pretreatment with topicals. 
Best
H Karamanoukian MD FACS

Melasma can not be completely cured, however effective treatment are possible. This is because your skin is extremely sensitive to UV and even the smallest amount can stimulate your pigment cells to produce colour. The mainstay of treatment is strict UV protection- hats, sunglasses and SPF every 4 hours.





I prefer to use a combination of creams and laser for melasma. Hydroquinone can be used (5-8%), along with vitamin A creams. I usually start my patients on laser (low dose Q switch or Picosure) a few weeks after they commence on creams. This way you can reduce the application of Kligmanans. 



In some cases I combine TCA or AHA peels, and in other cases I use a tablet called Tranexamic acid to help.





To maintain I use Clear + Brilliant with ascorbic acid, and HQ 2 times a week. 

All the best,





Dr Davin Lim



Laser, surgical and aesthetic dermatologist



Brisbane, Australia