Alternative Treatment for Melasma?

Hello,Melasma is a condition which requires multiple steps and treatments to effectively improve the condition consistently over time.  In our office, here are steps which are effective:
-Pico lasers- The best type of laser for improving the condition.  Please not it takes multiple steps to improve melasma safely
-Nd:YAG Nano lasers with toning- Here a laser is used for deeply resistant melasma to break up particles without generating excessive heat
-Melanage peels- A variety of peels can work and melanage is one of the best for melasma
-Skin topicals- A variety of products including use of lighteners (we prefer natural lighteners such as arubtase found in our product Luminoso) as well as sunscreens can help improve the condition
-Lifestyle choices-Avoiding the sun, hormonal changes (we have a hormone expert in Dr. Chughtai in our office) can all impact melasma.
While melasma is common, patients must understand a multi pronged approach is often the best strategy and controlling this condition.
Best, 
Anil Shah MD

Our protocol for melasma treatment is multi-pronged and includes laser therapy, fractional ablation, Covalent peels, and topical creams. I would begin the melarase creams for at least 4 to 6 weeks before initiating any aggressive laser therapy. AM: Melaclenz, Melapads, Melarase AMPM; Melaclenz, Melapads, Melarase PMBest, Dr. KaramanoukianRealself100 Surgeon

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 chronic condition that can be difficult to treat. Treatment usually consists of bleaching creams, such as the Tri-Luma that you mentioned and other treatments (lasers, peels) and lifestyle changes (sun-protective behaviors).  It is important to remember that bleaching creams should be monitored by your provider as you should not be on them long-term and must transition off and back on again throughout your management of this condition. Aside from creams, there are some lasers and peels that can help to minimize the appearance of melasma, but the single greatest thing you can do to help prevent it from getting worse is practicing sun-protective behaviors.  This means wearing high-quality sunscreen (and reapplying), wearing hats, and seeking shade. Inflammation, heat, and hormones also play a role in melasma, so remember activities that cause heat and inflammation (such as waxing, sitting in saunas) may make the pigment appear worse.  Because of its chronic nature, it is easy to be discouraged, but by seeing a provider experienced in treating melasma, you can have a management plan that it easy to follow. 

Melasma is usually a recurrent skin condition that can sometimes be difficult to treat. Most importantly, melasma treatment begins with wearing suncreen daily. I recommend at least SPF 50 with UVA and UVB coverage aling with a physical blocker like zinc oxide. Sunscreen does deactivate within about 2 hours so be sure to reapply.

There are some skin lightening alternatives on the market. Some studies have shown antioxidants such as vitamin C to help lighten some pigmentation Another is Elure which is a new product that my patients have been finding good success with lightening their skin.  This is a natural occuring enzyme and is therefore not found to be irritating to the skin. You apply it twice daily and most patients see results within a month; some have seen improvement within a weef or 2. You do still need to wear sunscreen and protect your skin to minimize recurrence of melasma

Melasma is an often chronic condition that is not easy to manage. First and foremost, I advise my patients to wear a high-quality SPF 60 sunscreen year round. Next, a combination cream like Triluma can be very effective, and I can compound much stronger fading creams than are available over the counter or that come prepared. Chemical peels carefully performed can sometimes be of benefit, as can laser in some cases. Vitamin C based creams are a useful adjunct as well. Finally, I find the Obaji system can be a very useful treatment and maintenance regimen for many of my patients with melasma.